Organization Active NPI

Nursing Aid

  • Adult Care Home Facility
  • Columbus, OH
National Provider Identifier
1417345356
Registry record updated Dec 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
License
401273120711 Issued in OH
Legal business name
NURSING AID
Practice address
410 Watersway Lane
Columbus, OH 43213
Phone
(614) 589-4874
NPI assigned
Dec 30, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2014

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

Authorized official

Name
Mr. Fikre Worku Fetene, NURSE AID
Title
Nurse Aid
Phone
(614) 589-4874

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X 401273120711 OH Primary

Addresses

Primary practice location

410 Watersway Lane
Columbus, OH 43213

Mailing address

410 Watersway LN
Columbus, OH 43213-6644
Phone (614) 589-4874

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1419897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419897600000",
    "number": "1417345356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 WATERSWAY LN",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432136644",
            "telephone_number": "614-589-4874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 WATERSWAY LANE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "43213",
            "telephone_number": "614-589-4874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NURSING AID",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-30",
        "last_updated": "2014-12-30",
        "status": "A",
        "authorized_official_last_name": "FETENE",
        "authorized_official_first_name": "FIKRE",
        "authorized_official_middle_name": "WORKU",
        "authorized_official_title_or_position": "NURSE AID",
        "authorized_official_telephone_number": "614-589-4874",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NURSE AID"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "OH",
            "license": "401273120711",
            "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 Dec 30, 2014; 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.