Individual provider Active NPI

Valerie T. Brazeau I, R.N.

  • Home Health Registered Nurse
  • Toledo, OH
National Provider Identifier
1225504475
Registry record updated Oct 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
RN.107414 Issued in OH
Practice address
2413 Pemberton Dr
Toledo, OH 43606-3176
Phone
(419) 509-6009
NPI assigned
Oct 15, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X RN.107414 OH Primary

Addresses

Primary practice location

2413 Pemberton Dr
Toledo, OH 43606-3176

Mailing address

10060 Bay Creek Rd
Erie, MI 48133-9304
Phone (734) 848-4784

Other identifiers 1

IdentifierTypeStateIssuer
6910304MedicaidOH

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN.107414OHMDHome Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1539561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539561600000",
    "number": "1225504475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10060 BAY CREEK RD",
            "city": "ERIE",
            "state": "MI",
            "postal_code": "481339304",
            "telephone_number": "734-848-4784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2413 PEMBERTON DR",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436063176",
            "telephone_number": "419-509-6009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAZEAU",
        "first_name": "VALERIE",
        "middle_name": "T.",
        "name_suffix": "I",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-15",
        "last_updated": "2018-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "OH",
            "license": "RN.107414",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6910304",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2018; 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.