Active NPI
Gustena Anderson, HOME HEALTH AIDE
- Home Health Agency
- Cleveland, OH
National Provider Identifier
1124390778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 137762
- Practice address
- 575 E 102ND St Apt 1
Cleveland, OH 44108-1385 - Phone
- (216) 355-6291
- NPI assigned
- Jan 28, 2012
- 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 Agency | 251E00000X | 137762 | OH | Primary |
Addresses
Primary practice location
575 E 102ND St Apt 1
Cleveland, OH 44108-1385
Mailing address
575 E 102ND St Apt 1
Cleveland, OH 44108-1385
Phone (216) 355-6291
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 137762 | Other | OH | HOME HEALTH AIDE |
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 |
|---|---|---|---|
| 137762 | OH | MD | Home Health Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1327708800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327708800000",
"number": "1124390778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "575 E 102ND ST APT 1",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441081385",
"telephone_number": "216-355-6291"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "575 E 102ND ST APT 1",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441081385",
"telephone_number": "216-355-6291"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "GUSTENA",
"credential": "HOME HEALTH AIDE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-01-28",
"last_updated": "2012-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "OH",
"license": "137762",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HOME HEALTH AIDE",
"identifier": "137762",
"state": "OH"
}
],
"endpoints": [],
"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 Jan 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.