Individual provider Active NPI

Tina Jo Ullman

  • Home Health Aide
  • Cleveland, OH
National Provider Identifier
1104424613
Registry record updated Oct 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
Practice address
2821 Portman Ave
Cleveland, OH 44109-4946
Phone
(216) 225-3985
NPI assigned
Oct 16, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X Primary

Addresses

Primary practice location

2821 Portman Ave
Cleveland, OH 44109-4946

Mailing address

2821 Portman Ave
Cleveland, OH 44109-4946
Phone (216) 225-3985

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL Cleveland Health Information Exchange (HIE)
CONNECT URL Cleveland Health Information Exchange (HIE)

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": "1602806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602806400000",
    "number": "1104424613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2821 PORTMAN AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441094946",
            "telephone_number": "216-225-3985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2821 PORTMAN AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441094946",
            "telephone_number": "216-225-3985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULLMAN",
        "first_name": "TINA",
        "middle_name": "JO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-16",
        "last_updated": "2020-10-16",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Cleveland",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Cleveland",
            "address_1": "2821 Portman Ave",
            "city": "Cleveland",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441094946",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Cleveland",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Cleveland",
            "address_1": "2821 Portman Ave",
            "city": "Cleveland",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441094946",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Oct 16, 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.