Individual provider Active NPI

Jessica Van Vleet, CDCA

  • Case Manager/Care Coordinator
  • Defiance, OH
National Provider Identifier
1346906716
Registry record updated Nov 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
CDCA.176411 Issued in OH
Practice address
511 Perry St
Defiance, OH 43512-2123
Phone
(419) 782-9920
NPI assigned
Nov 10, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X CDCA.176411 OH Primary

Addresses

Primary practice location

511 Perry St
Defiance, OH 43512-2123

Mailing address

511 Perry St
Defiance, OH 43512-2123
Phone (419) 782-9920

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
CDCA.176411OHMDCase Manager/Care Coordinator

Practice roles

OrganizationSpecialtyStatusNew patients
Maumee Valley Guidance Center Inc. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1636502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1346906716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 PERRY ST",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435122123",
            "telephone_number": "419-782-9920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 PERRY ST",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435122123",
            "telephone_number": "419-782-9920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN VLEET",
        "first_name": "JESSICA",
        "credential": "CDCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-10",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OH",
            "license": "CDCA.176411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Defiance, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2021; 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.