Individual provider Active NPI

Merissa S McCall

  • Nurse's Aide
  • Leesburg, OH
National Provider Identifier
1093016008
Registry record updated Nov 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
401054190310 Issued in OH
Practice address
11170 State Route 771
Leesburg, OH 45135-9394
Phone
(937) 344-1668
NPI assigned
Nov 7, 2010
Last updated
Nov 7, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X 401054190310 OH Primary

Addresses

Primary practice location

11170 State Route 771
Leesburg, OH 45135-9394

Mailing address

11170 State Route 771
Leesburg, OH 45135-9394
Phone (937) 344-1668

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
401054190310OHMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1289088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289088000000",
    "number": "1093016008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11170 STATE ROUTE 771",
            "city": "LEESBURG",
            "state": "OH",
            "postal_code": "451359394",
            "telephone_number": "937-344-1668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11170 STATE ROUTE 771",
            "city": "LEESBURG",
            "state": "OH",
            "postal_code": "451359394",
            "telephone_number": "937-344-1668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCALL",
        "first_name": "MERISSA",
        "middle_name": "S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-07",
        "last_updated": "2010-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "OH",
            "license": "401054190310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2010; 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.