Individual provider Active NPI

Quivadise Scott

  • Nurse's Aide
  • Cleveland, OH
National Provider Identifier
1073913620
Registry record updated Sep 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
401592001113 Issued in OH
Practice address
2592 Dillard St
Cleveland, OH 44115-3737
Phone
(216) 331-5991
NPI assigned
Sep 2, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Companion 372600000X 401592001113 OH
Home Health Aide 374U00000X 401592001113 OH
Nurse's Aide 376K00000X 401592001113 OH Primary

Addresses

Primary practice location

2592 Dillard St
Cleveland, OH 44115-3737

Mailing address

2592 Dillard St
Cleveland, OH 44115-3737
Phone (216) 331-5991

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
401592001113OHMDHome Health Aide

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1409616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409616000000",
    "number": "1073913620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2592 DILLARD ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441153737",
            "telephone_number": "216-331-5991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2592 DILLARD ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441153737",
            "telephone_number": "216-331-5991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "QUIVADISE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-02",
        "last_updated": "2014-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": "OH",
            "license": "401592001113",
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "OH",
            "license": "401592001113",
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "OH",
            "license": "401592001113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.