Individual provider Active NPI

Carrie S Botticher

  • Home Health Aide
  • Tipp City, OH
National Provider Identifier
1407907322
Registry record updated Feb 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
Practice address
533 W Main St
Tipp City, OH 45371-1438
Phone
(937) 667-5399
Fax
(937) 667-5399
NPI assigned
Jan 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X Primary

Addresses

Primary practice location

533 W Main St
Tipp City, OH 45371-1438

Mailing address

533 W Main St
Tipp City, OH 45371-1438
Phone (937) 667-5399

Other identifiers 1

IdentifierTypeStateIssuer
2471632MedicaidOH

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

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644969600000",
    "number": "1407907322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "533 W MAIN ST",
            "city": "TIPP CITY",
            "state": "OH",
            "postal_code": "453711438",
            "telephone_number": "937-667-5399",
            "fax_number": "937-667-5399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "533 W MAIN ST",
            "city": "TIPP CITY",
            "state": "OH",
            "postal_code": "453711438",
            "telephone_number": "937-667-5399",
            "fax_number": "937-667-5399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTTICHER",
        "first_name": "CARRIE",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2471632",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tipp City, OH

Sources for this page

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