Individual provider Active NPI

Madalyn Renee Sibble, STNA

  • Nurse's Aide
  • Massillon, OH
National Provider Identifier
1396596987
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
402058200418 Issued in OH
Practice address
507 Oak Manor Ave NE
Massillon, OH 44646-4035
Phone
(330) 581-8027
NPI assigned
Apr 1, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X 402058200418 OH Primary

Addresses

Primary practice location

507 Oak Manor Ave NE
Massillon, OH 44646-4035

Mailing address

507 Oak Manor Ave NE
Massillon, OH 44646-4035
Phone (330) 581-8027

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
402058200418OHMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1711929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1396596987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 OAK MANOR AVE NE",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446464035",
            "telephone_number": "330-581-8027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 OAK MANOR AVE NE",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446464035",
            "telephone_number": "330-581-8027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIBBLE",
        "first_name": "MADALYN",
        "middle_name": "RENEE",
        "credential": "STNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-01",
        "last_updated": "2024-04-01",
        "certification_date": "2024-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "OH",
            "license": "402058200418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Massillon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; 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.