Active NPI
Eric R Davis
- Home Health Aide
- Columbus, OH
National Provider Identifier
1376083089
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- License
- ST170576
- Practice address
- 3540 Red Clover PL
Columbus, OH 43224-3007 - Phone
- (614) 571-1351
- Fax
- (614) 929-3230
- NPI assigned
- Feb 28, 2017
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | ST170576 | OH | Primary |
Addresses
Primary practice location
3540 Red Clover PL
Columbus, OH 43224-3007
Mailing address
3540 Red Clover PL
Columbus, OH 43224-3007
Phone (614) 571-1351
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 |
|---|---|---|---|
| ST170576 | OH | MD | Home Health Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1488240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1488240000000",
"number": "1376083089",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3540 RED CLOVER PL",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432243007",
"telephone_number": "614-571-1351",
"fax_number": "614-929-3230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3540 RED CLOVER PL",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432243007",
"telephone_number": "614-571-1351",
"fax_number": "614-929-3230"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "ERIC",
"middle_name": "R",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-02-28",
"last_updated": "2017-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "OH",
"license": "ST170576",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.