Jami Lynn Hackworth, LPN
Individual provider Active NPI Licensed Practical Nurse · Pedro, OH
NPI 1174847115 · NPPES record last updated Mar 19, 2010
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Sep 19, 2019.
Key facts
- NPI
- 1174847115
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- PN . 128734 (OH)
- Practice address
- 201 Private Road 349 Rear
Pedro, OH 45659-8925 - Phone
- (740) 532-5515
- NPI assigned
- Mar 19, 2010
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PN . 128734 | OH | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | PN . 128734 | OH | Yes |
Addresses
Primary practice location
201 Private Road 349 Rear
Pedro, OH 45659-8925
Mailing address
201 Private Road 349 Rear
Pedro, OH 45659-8925
Phone (740) 532-5515
Other providers in Pedro, OH
- Kelsi Gothard
- Wilson Tyler Grimmett
- Sara Griswold
- Donna Irene Gullett
- Haley Nicole Hackney
- Absalom Solomon Hall
- Jenifer Hall
- Leslie Ann Hammond
- Karlyn Marie Hanford
- Julie Hankins
All providers in Pedro, OH · Licensed Practical Nurse in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 19, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- OIG LEIE (HHS Office of Inspector General).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.