Progressive Individual Care

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

PROGRESSIVE INDIVIDUAL CARE

Practice address

5631 Alexis Rd
Sylvania, OH 43560-2355

Phone

(419) 360-6573

Fax

(419) 824-0809

NPI assigned

Jun 16, 2020

Last updated

Jun 16, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Melody Blattner

Title

Ceo

Phone

(419) 360-6573

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1592265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592265600000",
    "number": "1346865383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5631 ALEXIS RD",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602355",
            "telephone_number": "419-360-6573",
            "fax_number": "419-824-0809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5631 ALEXIS RD",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602355",
            "telephone_number": "419-360-6573",
            "fax_number": "419-824-0809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE INDIVIDUAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-16",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A",
        "authorized_official_last_name": "BLATTNER",
        "authorized_official_first_name": "MELODY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "419-360-6573"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4809649",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "melody@pic-care.com",
            "affiliation": "N",
            "endpointDescription": "CEO email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "5631 Alexis Rd",
            "city": "Sylvania",
            "state": "OH",
            "country_code": "US",
            "postal_code": "435602355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2020; 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.