Active NPI
Gwendolyn Hoover
- Licensed Practical Nurse
- Ypsilanti, MI
National Provider Identifier
1366958647
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 4703104755
- Practice address
- 300 N Huron St Ste 10
Ypsilanti, MI 48197-2842 - Phone
- (734) 480-0125
- NPI assigned
- Dec 21, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 4703104755 | MI | Primary |
Addresses
Primary practice location
300 N Huron St Ste 10
Ypsilanti, MI 48197-2842
Mailing address
48160 Hull Rd
Belleville, MI 48111-4280
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629279732 | Medicaid | MI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4703104755 | MI | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Personal Touch Home Health Care Services Inc | Past | Accepting new patients | |
| Personal Touch Home Health Care Services Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Home Health Agency
- Ypsilanti, MI
- NPI 1629279732
-
- Home Health Agency
- Ypsilanti, MI
- NPI 1871353862
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1513814400000",
"number": "1366958647",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "48160 HULL RD",
"city": "BELLEVILLE",
"state": "MI",
"postal_code": "481114280"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 N HURON ST STE 10",
"city": "YPSILANTI",
"state": "MI",
"postal_code": "481972842",
"telephone_number": "734-480-0125"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOOVER",
"first_name": "GWENDOLYN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-12-21",
"last_updated": "2017-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "MI",
"license": "4703104755",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1629279732",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ypsilanti, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.