Jeff Allen Homich

Primary specialty

Home Modifications ContractorTaxonomy code 171WH0202X

Practice address

112 Wyandotte Rd
Hoyt Lakes, MN 55750-1224

Phone

(218) 994-2252

NPI assigned

Mar 11, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1646956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646956800000",
    "number": "1407504293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 WYANDOTTE RD",
            "city": "HOYT LAKES",
            "state": "MN",
            "postal_code": "557501224",
            "telephone_number": "218-994-2252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 WYANDOTTE RD",
            "city": "HOYT LAKES",
            "state": "MN",
            "postal_code": "557501224",
            "telephone_number": "218-994-2252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOMICH",
        "first_name": "JEFF",
        "middle_name": "ALLEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-11",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171WH0202X",
            "taxonomy_group": "",
            "desc": "Contractor, Home Modifications",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• City of Hoyt Lakes
• Mary Fossell, RPH
• Alexis Jade Hammond
• Healing Center LLC
• Bryan Ann Johnson, LSW
• Darrell John Leier, M.D.
• Mesaba Drug Inc
• Thrifty Drug Stores, Inc.
• Twin City Christian Homes Services Company

• Home Modifications Contractor in Hoyt Lakes, MN
• Providers in Hoyt Lakes, MN by specialty
• Home Modifications Contractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2022; 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.