Individual provider Active NPI

Fred Steven Elliott

  • Driver
  • Coshocton, OH
National Provider Identifier
1164987749
Registry record updated Feb 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DriverTaxonomy code 172A00000X
License
RP532801 Issued in OH
Practice address
552 Wilson Ave
Coshocton, OH 43812-2358
Phone
(740) 575-6564
Fax
(740) 722-9008
NPI assigned
Feb 7, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X RP532801 OH Primary

Addresses

Primary practice location

552 Wilson Ave
Coshocton, OH 43812-2358

Mailing address

552 Wilson Ave
Coshocton, OH 43812-2358
Phone (740) 575-6564

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

LicenseStateTypeSpecialty
RP532801OHMDDriver

NPI Registry JSON

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

{
    "created_epoch": "1549497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549497600000",
    "number": "1164987749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "552 WILSON AVE",
            "city": "COSHOCTON",
            "state": "OH",
            "postal_code": "438122358",
            "telephone_number": "740-575-6564",
            "fax_number": "740-722-9008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "552 WILSON AVE",
            "city": "COSHOCTON",
            "state": "OH",
            "postal_code": "438122358",
            "telephone_number": "740-575-6564",
            "fax_number": "740-722-9008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "FRED",
        "middle_name": "STEVEN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-02-07",
        "last_updated": "2019-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "OH",
            "license": "RP532801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coshocton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2019; 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.