Active NPI
Bobby Burnett
- Home Health Aide
- Canton, OH
National Provider Identifier
1104525468
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- Practice address
- 3042 Ellis Ave NE
Canton, OH 44705-4945 - Phone
- (330) 949-5537
- NPI assigned
- Feb 27, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | OH | Primary |
Addresses
Primary practice location
3042 Ellis Ave NE
Canton, OH 44705-4945
Mailing address
3042 Ellis Ave NE
Canton, OH 44705-4945
Phone (330) 949-5537
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01877049 | Medicaid | OH |
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": "1677456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677456000000",
"number": "1104525468",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3042 ELLIS AVE NE",
"city": "CANTON",
"state": "OH",
"postal_code": "447054945",
"telephone_number": "330-949-5537"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3042 ELLIS AVE NE",
"city": "CANTON",
"state": "OH",
"postal_code": "447054945",
"telephone_number": "330-949-5537"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURNETT",
"first_name": "BOBBY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-02-27",
"last_updated": "2023-02-27",
"certification_date": "2023-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "OH",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01877049",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Canton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.