Active NPI
Carrilynn Evelyn Elayne Jewell
- Home Health Aide
- Defiance, OH
National Provider Identifier
1417473406
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- License
- UD592568
- Practice address
- 702 Ravine Ave
Defiance, OH 43512-3148 - Phone
- (419) 980-5978
- NPI assigned
- Aug 21, 2017
- Last updated
- Jul 21, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | UD592568 | OH | Primary |
Addresses
Primary practice location
702 Ravine Ave
Defiance, OH 43512-3148
Mailing address
702 Ravine Ave
Defiance, OH 43512-3148
Phone (419) 980-5978
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A0P170975-01 | Other | OH | PARAMOUNT ADVANTAGE |
| A00170975 | Other | OH | PARAMOUNT ADVANTAGE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| UD592568 | OH | MD | Home Health Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1417473406",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "702 RAVINE AVE",
"city": "DEFIANCE",
"state": "OH",
"postal_code": "435123148",
"telephone_number": "419-980-5978"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "702 RAVINE AVE",
"city": "DEFIANCE",
"state": "OH",
"postal_code": "435123148",
"telephone_number": "419-980-5978"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEWELL",
"first_name": "CARRILYNN",
"middle_name": "EVELYN ELAYNE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-08-21",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "OH",
"license": "UD592568",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PARAMOUNT ADVANTAGE",
"identifier": "A0P170975-01",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PARAMOUNT ADVANTAGE",
"identifier": "A00170975",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Defiance, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.