Individual provider Active NPI

Nicole Marie Descenna

  • Peer Specialist
  • Warren, OH
National Provider Identifier
1083200240
Registry record updated Dec 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
8466 Carriage Hill Dr NE
Warren, OH 44484-1661
Phone
(216) 760-2668
NPI assigned
Dec 11, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X OH Primary

Addresses

Primary practice location

8466 Carriage Hill Dr NE
Warren, OH 44484-1661

Mailing address

8466 Carriage Hill Dr NE
Warren, OH 44484-1661
Phone (216) 760-2668

Other identifiers 1

IdentifierTypeStateIssuer
17500000XMedicaidOH

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

NPI Registry JSON

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

{
    "created_epoch": "1607644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1083200240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8466 CARRIAGE HILL DR NE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444841661",
            "telephone_number": "216-760-2668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8466 CARRIAGE HILL DR NE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444841661",
            "telephone_number": "216-760-2668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESCENNA",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-11",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17500000X",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; 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.