Individual provider Active NPI

Amanda Lynece Marsh

  • Nurse's Aide
  • Cleveland, OH
National Provider Identifier
1245512789
Registry record updated Sep 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
401286030811 Issued in OH
Practice address
11926 Griffing Ave
Cleveland, OH 44120-3014
Phone
(216) 233-8788
NPI assigned
Sep 11, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X 401286030811 OH Primary

Addresses

Primary practice location

11926 Griffing Ave
Cleveland, OH 44120-3014

Mailing address

11926 Griffing Ave
Cleveland, OH 44120-3014
Phone (216) 233-8788

Other identifiers 1

IdentifierTypeStateIssuer
401286030811MedicaidOH

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
401286030811OHMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1315699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315699200000",
    "number": "1245512789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11926 GRIFFING AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441203014",
            "telephone_number": "216-233-8788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11926 GRIFFING AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441203014",
            "telephone_number": "216-233-8788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSH",
        "first_name": "AMANDA",
        "middle_name": "LYNECE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-11",
        "last_updated": "2011-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "OH",
            "license": "401286030811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "401286030811",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2011; 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.