Individual provider Active NPI

Julie Hadden

  • In Home Supportive Care Agency
  • Cedarville, OH
National Provider Identifier
1164811477
Registry record updated Oct 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Practice address
3751 James Barber Rd
Cedarville, OH 45314-9710
Phone
(937) 581-0105
NPI assigned
Jan 10, 2015
Last updated
Oct 9, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X
Home Health Aide 374U00000X 2903997 OH
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

3751 James Barber Rd
Cedarville, OH 45314-9710

Mailing address

3751 James Barber Rd
Cedarville, OH 45314-9710
Phone (937) 581-0105

Other practice location 1

2803 Kemp Rd
Beavercreek, OH 45431-2640
Phone (937) 581-0105

Other identifiers 3

IdentifierTypeStateIssuer
3747P1801XMedicaidOH
0115279MedicaidOH
253Z00000XMedicaidOH

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

LicenseStateTypeSpecialty
2903997OHMDHome Health Aide

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1420848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602201600000",
    "number": "1164811477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3751 JAMES BARBER RD",
            "city": "CEDARVILLE",
            "state": "OH",
            "postal_code": "453149710",
            "telephone_number": "937-581-0105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3751 JAMES BARBER RD",
            "city": "CEDARVILLE",
            "state": "OH",
            "postal_code": "453149710",
            "telephone_number": "937-581-0105"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2803 Kemp Rd",
            "address_purpose": "LOCATION",
            "city": "Beavercreek",
            "state": "OH",
            "postal_code": "454312640",
            "country_code": "US",
            "telephone_number": "937-581-0105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HADDEN",
        "first_name": "JULIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-10",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "OH",
            "license": "2903997",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3747P1801X",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0115279",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "253Z00000X",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedarville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2020; 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.