Active NPI
Erica Dormer, INDEPENDENT PROVIDER
- Homemaker
- Willowick, OH
National Provider Identifier
1124870241
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Homemaker
- License
- TU118627
- Practice address
- 29505 Green Dr
Willowick, OH 44095-4713 - Phone
- (216) 904-8038
- NPI assigned
- Apr 2, 2024
- 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 |
|---|---|---|---|---|
| Homemaker | 376J00000X | TU118627 | OH | Primary |
Addresses
Primary practice location
29505 Green Dr
Willowick, OH 44095-4713
Mailing address
29505 Green Dr
Willowick, OH 44095-4713
Phone (216) 904-8038
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 |
|---|---|---|---|
| TU118627 | OH | MD | Homemaker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1712016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712016000000",
"number": "1124870241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29505 GREEN DR",
"city": "WILLOWICK",
"state": "OH",
"postal_code": "440954713",
"telephone_number": "216-904-8038"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29505 GREEN DR",
"city": "WILLOWICK",
"state": "OH",
"postal_code": "440954713",
"telephone_number": "216-904-8038"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DORMER",
"first_name": "ERICA",
"credential": "INDEPENDENT PROVIDER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-04-02",
"last_updated": "2024-04-02",
"certification_date": "2024-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "376J00000X",
"taxonomy_group": "",
"desc": "Homemaker",
"state": "OH",
"license": "TU118627",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Willowick, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 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.