Individual provider Active NPI

Stacie Lynn Kovach

  • Homemaker
  • Medina, OH
National Provider Identifier
1184227274
Registry record updated Nov 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
HomemakerTaxonomy code 376J00000X
License
2391979 Issued in OH
Practice address
7051 Chippewa Rd
Medina, OH 44256-8517
Phone
(330) 606-8040
NPI assigned
Nov 19, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Homemaker 376J00000X
Homemaker 376J00000X 2391979 OH Primary

Addresses

Primary practice location

7051 Chippewa Rd
Medina, OH 44256-8517

Mailing address

7051 Chippewa Rd
Medina, OH 44256-8517
Phone (330) 606-8040

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
2391979OHMDHomemaker

NPI Registry JSON

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

{
    "created_epoch": "1605744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605744000000",
    "number": "1184227274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7051 CHIPPEWA RD",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442568517",
            "telephone_number": "330-606-8040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7051 CHIPPEWA RD",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442568517",
            "telephone_number": "330-606-8040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVACH",
        "first_name": "STACIE",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-19",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": "OH",
            "license": "2391979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medina, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.