Active NPI
Latoyia Woodson Burgess
- In Home Supportive Care Agency
- Holland, OH
National Provider Identifier
1104602358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- Practice address
- 650 Whisperwood Pkwy
Holland, OH 43528-7868 - Phone
- (567) 686-9272
- NPI assigned
- Sep 5, 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 12
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | |||
| Homemaker | 376J00000X | |||
| In Home Supportive Care Agency | 253Z00000X | Primary | ||
| Nurse's Aide | 376K00000X | |||
| Respite Care | 385H00000X | |||
| Licensed Practical Nurse | 164W00000X | LPN.155018.MEDS-IV | OH | |
| Secured Medical Transport (VAN) | 343800000X | |||
| Non-emergency Medical Transport (VAN) | 343900000X | |||
| Driver | 172A00000X | |||
| Meals Provider | 174200000X | |||
| Nursing Care Agency | 251J00000X | |||
| Adult Day Care Clinic/Center | 261QA0600X |
Addresses
Primary practice location
650 Whisperwood Pkwy
Holland, OH 43528-7868
Mailing address
650 Whisperwood Pkwy
Holland, OH 43528-7868
Phone (567) 686-9272
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
| License | State | Type | Specialty |
|---|---|---|---|
| LPN.155018.MEDS-IV | OH | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Circle of Care Homes LLC | Licensed Practical Nurse | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- In Home Supportive Care Agency
- Holland, OH
- NPI 1679349922
Licensed Practical Nurse
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1693872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699920000000",
"number": "1104602358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "650 WHISPERWOOD PKWY",
"city": "HOLLAND",
"state": "OH",
"postal_code": "435287868",
"telephone_number": "567-686-9272"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 WHISPERWOOD PKWY",
"city": "HOLLAND",
"state": "OH",
"postal_code": "435287868",
"telephone_number": "567-686-9272"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURGESS",
"first_name": "LATOYIA",
"middle_name": "WOODSON",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-09-05",
"last_updated": "2023-11-14",
"certification_date": "2023-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Home Health Aide",
"state": null,
"license": null,
"primary": false
},
{
"code": "376J00000X",
"taxonomy_group": "",
"desc": "Homemaker",
"state": null,
"license": null,
"primary": false
},
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": null,
"license": null,
"primary": true
},
{
"code": "376K00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse's Aide",
"state": null,
"license": null,
"primary": false
},
{
"code": "385H00000X",
"taxonomy_group": "",
"desc": "Respite Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "OH",
"license": "LPN.155018.MEDS-IV",
"primary": false
},
{
"code": "343800000X",
"taxonomy_group": "",
"desc": "Secured Medical Transport (VAN)",
"state": null,
"license": null,
"primary": false
},
{
"code": "343900000X",
"taxonomy_group": "",
"desc": "Non-emergency Medical Transport (VAN)",
"state": null,
"license": null,
"primary": false
},
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": null,
"license": null,
"primary": false
},
{
"code": "174200000X",
"taxonomy_group": "",
"desc": "Meals",
"state": null,
"license": null,
"primary": false
},
{
"code": "251J00000X",
"taxonomy_group": "",
"desc": "Nursing Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QA0600X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adult Day Care",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Holland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.