Active NPI
Paula Brenda Gregory, PERSONAL CARE AIDE
- Home Health Aide
- Willowick, OH
National Provider Identifier
1164168399
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- Practice address
- 30707 Lake Shore Blvd Apt 206
Willowick, OH 44095-3669 - Phone
- (440) 477-4264
- NPI assigned
- May 10, 2022
- Last updated
- May 10, 2022
- Sex
- Female
- Sole proprietor
- No
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 | NU | Primary |
Addresses
Primary practice location
30707 Lake Shore Blvd Apt 206
Willowick, OH 44095-3669
Mailing address
316 Blissfield Dr
Willowick, OH 44095-5043
Phone (440) 749-3494
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": "1652140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652140800000",
"number": "1164168399",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "316 BLISSFIELD DR",
"city": "WILLOWICK",
"state": "OH",
"postal_code": "440955043",
"telephone_number": "440-749-3494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30707 LAKE SHORE BLVD APT 206",
"city": "WILLOWICK",
"state": "OH",
"postal_code": "440953669",
"telephone_number": "440-477-4264"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREGORY",
"first_name": "PAULA",
"middle_name": "BRENDA",
"name_prefix": "Mrs.",
"credential": "PERSONAL CARE AIDE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-10",
"last_updated": "2022-05-10",
"certification_date": "2022-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "NU",
"license": null,
"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 May 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.