Individual provider Active NPI

Paula Brenda Gregory, PERSONAL CARE AIDE

  • Home Health Aide
  • Willowick, OH
National Provider Identifier
1164168399
Registry record updated May 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
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, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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.

Verify at the official NPI Registry.