Individual provider Active NPI

Brittany Ann Nichole Scisum

  • Licensed Practical Nurse
  • Toledo, OH
National Provider Identifier
1083288872
Registry record updated May 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
170784 Issued in OH
Practice address
4672 S Park LN
Toledo, OH 43614-3165
Phone
(419) 464-5314
NPI assigned
May 17, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 170784 OH Primary

Addresses

Primary practice location

4672 S Park LN
Toledo, OH 43614-3165

Mailing address

4672 S Park LN BLDG 11
Toledo, OH 43614-3165
Phone (419) 464-5314

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
170784OHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1621209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621209600000",
    "number": "1083288872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4672 S PARK LN BLDG 11",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436143165",
            "telephone_number": "419-464-5314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4672 S PARK LN",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436143165",
            "telephone_number": "419-464-5314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCISUM",
        "first_name": "BRITTANY",
        "middle_name": "ANN NICHOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-17",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "170784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2021; 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.