Trisha L Endicott – Home Modifications Contractor

Key facts

NPI: 1346466976
Entity type: Individual (NPI type 1)
Primary specialty: Home Modifications Contractor 171WH0202X
License: 2104234 (OH)
Practice address: 11999 Steubenville Pike
Lisbon, OH 44432-9707
Phone: (330) 424-4737
NPI assigned: Apr 18, 2007
Sex: Female
Sole proprietor: Yes

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
2104234	OH	MD	Home Modifications Contractor

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Home Modifications Contractor	171WH0202X	2104234	OH	Yes

Addresses

Primary practice location

11999 Steubenville Pike
Lisbon, OH 44432-9707

Mailing address

11999 Steubenville Pike
Lisbon, OH 44432-9707
Phone (330) 424-4737

Other identifiers

Identifier	Type	State	Issuer
107085842699	Medicaid	OH
171027384601	Medicaid	OH

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 9, 2007.

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1346466976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11999 STEUBENVILLE PIKE",
            "city": "LISBON",
            "state": "OH",
            "postal_code": "444329707",
            "telephone_number": "330-424-4737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11999 STEUBENVILLE PIKE",
            "city": "LISBON",
            "state": "OH",
            "postal_code": "444329707",
            "telephone_number": "330-424-4737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENDICOTT",
        "first_name": "TRISHA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171WH0202X",
            "taxonomy_group": "",
            "desc": "Contractor, Home Modifications",
            "state": "OH",
            "license": "2104234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "107085842699",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171027384601",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lisbon, OH

All providers in Lisbon, OH · Home Modifications Contractor in Ohio

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.