Shirley A Whitaker
Individual provider Active NPI Home Health Agency · Prospect, OH
NPI 1144823949 · NPPES record last updated Nov 16, 2020
Key facts
- NPI
- 1144823949
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Home Health Agency 251E00000X
- License
- 2882420 (OH)
- Practice address
- 6699 Dunbar Rd
Prospect, OH 43342-9772 - Phone
- (740) 513-6238
- NPI assigned
- Nov 16, 2020
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2882420 | OH | MD | Home Health Agency |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 2882420 | OH | Yes |
Addresses
Primary practice location
6699 Dunbar Rd
Prospect, OH 43342-9772
Mailing address
6699 Dunbar Rd
Prospect, OH 43342-9772
Phone (740) 513-6238
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2882420 | Medicaid | OH |
Other providers in Prospect, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 16, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.