Individual provider Active NPI

Evelyn Wheeler-Dorsey

  • In Home Supportive Care Agency
  • Cleveland, OH
National Provider Identifier
1396443412
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
79934543 Issued in OH
Practice address
1481 E 65TH St
Cleveland, OH 44103-2655
Phone
(216) 536-8619
NPI assigned
Feb 17, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
In Home Supportive Care Agency 253Z00000X 79934543 OH Primary

Addresses

Primary practice location

1481 E 65TH St
Cleveland, OH 44103-2655

Mailing address

1481 E 65TH St
Cleveland, OH 44103-2655
Phone (216) 536-8619

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
79934543OHMDIn Home Supportive Care Agency

NPI Registry JSON

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

{
    "created_epoch": "1676592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1396443412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1481 E 65TH ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441032655",
            "telephone_number": "216-536-8619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1481 E 65TH ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441032655",
            "telephone_number": "216-536-8619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEELER-DORSEY",
        "first_name": "EVELYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-17",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "OH",
            "license": "79934543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; 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.