Active NPI
Curtis Allen Clark
- Home Health Aide
- Beaver, OH
National Provider Identifier
1194315077
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- Practice address
- 1124 Millstone Rd
Beaver, OH 45613-9493 - Phone
- (740) 708-2950
- NPI assigned
- Jan 25, 2021
- Last updated
- Jan 25, 2021
- Sex
- Male
- 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 | NU | Primary |
Addresses
Primary practice location
1124 Millstone Rd
Beaver, OH 45613-9493
Mailing address
1124 Millstone Rd
Beaver, OH 45613-9493
Phone (740) 708-2950
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3094842 | Medicaid | OH |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611532800000",
"number": "1194315077",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1124 MILLSTONE RD",
"city": "BEAVER",
"state": "OH",
"postal_code": "456139493",
"telephone_number": "740-708-2950"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1124 MILLSTONE RD",
"city": "BEAVER",
"state": "OH",
"postal_code": "456139493",
"telephone_number": "740-708-2950"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "CURTIS",
"middle_name": "ALLEN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-01-25",
"last_updated": "2021-01-25",
"certification_date": "2021-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3094842",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Beaver, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.