Kimberley Ann Novak Trentanelli

Key facts

NPI

1205439239

Entity type

Individual (NPI type 1)

Primary specialty

In Home Supportive Care Agency 253Z00000X

Practice address

7629 S Boyden Rd
Sagamore Hills, OH 44067-2436

Phone

(216) 526-0109

NPI assigned

Nov 20, 2020

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

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 20, 2020.

{
    "created_epoch": "1605830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605830400000",
    "number": "1205439239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7629 S BOYDEN RD",
            "city": "SAGAMORE HILLS",
            "state": "OH",
            "postal_code": "440672436",
            "telephone_number": "216-526-0109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7629 S BOYDEN RD",
            "city": "SAGAMORE HILLS",
            "state": "OH",
            "postal_code": "440672436",
            "telephone_number": "216-526-0109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVAK TRENTANELLI",
        "first_name": "KIMBERLEY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-20",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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