Active NPI
Amy Sue Wilcox
- Home Health Agency
- Port Clinton, OH
National Provider Identifier
1245597236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Practice address
- 316 1/2 Laurel Ave
Port Clinton, OH 43452-1811 - Phone
- (419) 889-9464
- NPI assigned
- Apr 16, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | |||
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
316 1/2 Laurel Ave
Port Clinton, OH 43452-1811
Mailing address
316 1/2 Laurel Ave
Port Clinton, OH 43452-1811
Phone (419) 889-9464
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0062118 | 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": "1334534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692662400000",
"number": "1245597236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "316 1/2 LAUREL AVE",
"city": "PORT CLINTON",
"state": "OH",
"postal_code": "434521811",
"telephone_number": "419-889-9464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "316 1/2 LAUREL AVE",
"city": "PORT CLINTON",
"state": "OH",
"postal_code": "434521811",
"telephone_number": "419-889-9464"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILCOX",
"first_name": "AMY",
"middle_name": "SUE",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-04-16",
"last_updated": "2023-08-22",
"certification_date": "2023-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": null,
"license": null,
"primary": false
},
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0062118",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Port Clinton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.