Individual provider Active NPI

Annette Bakie Kallon

  • In Home Supportive Care Agency
  • Columbus, OH
National Provider Identifier
1093556359
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Practice address
3880 White Pond Dr Apt 102
Columbus, OH 43219-3993
Phone
(803) 440-7422
NPI assigned
Jun 3, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
DriverGroup: 193200000X MULTI-SPECIALTY GROUP 172A00000X SU625686 OH
Meals Provider 174200000X
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

3880 White Pond Dr Apt 102
Columbus, OH 43219-3993

Mailing address

3880 White Pond Dr Apt 102
Columbus, OH 43219-3993
Phone (803) 440-7422

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
SU625686OHMDDriver

NPI Registry JSON

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

{
    "created_epoch": "1717372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1093556359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3880 WHITE POND DR APT 102",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432193993",
            "telephone_number": "803-440-7422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3880 WHITE POND DR APT 102",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432193993",
            "telephone_number": "803-440-7422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALLON",
        "first_name": "ANNETTE",
        "middle_name": "BAKIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-03",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Driver",
            "state": "OH",
            "license": "SU625686",
            "primary": false
        },
        {
            "code": "174200000X",
            "taxonomy_group": "",
            "desc": "Meals",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; 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.