Individual provider Active NPI

Charles Jermaine Hargrow

  • In Home Supportive Care Agency
  • Blacklick, OH
National Provider Identifier
1285359950
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
RR887369 Issued in OH
Practice address
882 Dressage Trce
Blacklick, OH 43004-9163
Phone
(614) 595-9673
NPI assigned
Oct 5, 2022
Last updated
Oct 5, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X RR887369 OH Primary

Addresses

Primary practice location

882 Dressage Trce
Blacklick, OH 43004-9163

Mailing address

882 Dressage Trce
Blacklick, OH 43004-9163
Phone (614) 595-9673

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
RR887369OHMDIn Home Supportive Care Agency

NPI Registry JSON

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

{
    "created_epoch": "1664928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1285359950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "882 DRESSAGE TRCE",
            "city": "BLACKLICK",
            "state": "OH",
            "postal_code": "430049163",
            "telephone_number": "614-595-9673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "882 DRESSAGE TRCE",
            "city": "BLACKLICK",
            "state": "OH",
            "postal_code": "430049163",
            "telephone_number": "614-595-9673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARGROW",
        "first_name": "CHARLES",
        "middle_name": "JERMAINE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-05",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "OH",
            "license": "RR887369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blacklick, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; 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.