Individual provider Active NPI

Trey V Ford

  • In Home Supportive Care Agency
  • South Euclid, OH
National Provider Identifier
1235963448
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
UM622867 Issued in OH
Practice address
3846 Grosvenor Rd
South Euclid, OH 44118-2314
Phone
(440) 283-9686
NPI assigned
Aug 29, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X UM622867 OH
In Home Supportive Care Agency 253Z00000X UM622867 OH Primary

Addresses

Primary practice location

3846 Grosvenor Rd
South Euclid, OH 44118-2314

Mailing address

3841 Grosvenor Rd
South Euclid, OH 44118-2313
Phone (440) 283-9686

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
UM622867OHMDIn Home Supportive Care Agency

NPI Registry JSON

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

{
    "created_epoch": "1724889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1235963448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3841 GROSVENOR RD",
            "city": "SOUTH EUCLID",
            "state": "OH",
            "postal_code": "441182313",
            "telephone_number": "440-283-9686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3846 GROSVENOR RD",
            "city": "SOUTH EUCLID",
            "state": "OH",
            "postal_code": "441182314",
            "telephone_number": "440-283-9686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "TREY",
        "middle_name": "V",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-08-29",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "OH",
            "license": "UM622867",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "OH",
            "license": "UM622867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Euclid, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; 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.