Active NPI
Tasha Douglass
- Home Health Aide
- Fairfield, OH
National Provider Identifier
1164845855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- License
- 401549410713
- Practice address
- 25 Heffron Dr Apt 9
Fairfield, OH 45014-7720 - Phone
- (513) 805-6564
- NPI assigned
- Jan 30, 2014
- 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 |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | 401549410713 | OH | Primary |
Addresses
Primary practice location
25 Heffron Dr Apt 9
Fairfield, OH 45014-7720
Mailing address
25 Heffron Dr Apt 9
Fairfield, OH 45014-7720
Phone (513) 805-6564
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 |
|---|---|---|---|
| 401549410713 | OH | MD | Home Health Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1391040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391040000000",
"number": "1164845855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 HEFFRON DR APT 9",
"city": "FAIRFIELD",
"state": "OH",
"postal_code": "450147720",
"telephone_number": "513-805-6564"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 HEFFRON DR APT 9",
"city": "FAIRFIELD",
"state": "OH",
"postal_code": "450147720",
"telephone_number": "513-805-6564"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUGLASS",
"first_name": "TASHA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-01-30",
"last_updated": "2014-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "OH",
"license": "401549410713",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.