Active NPI
Justin Jamison
- Home Modifications Contractor
- Sidney, OH
National Provider Identifier
1447090972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Modifications Contractor
- Practice address
- 18790 Suber Rd
Sidney, OH 45365-8785 - Phone
- (937) 606-1158
- NPI assigned
- May 31, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Modifications Contractor | 171WH0202X | Primary | ||
| Contractor | 171W00000X |
Addresses
Primary practice location
18790 Suber Rd
Sidney, OH 45365-8785
Mailing address
18790 Suber Rd
Sidney, OH 45365-8785
Phone (937) 606-1158
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": "1717113600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717113600000",
"number": "1447090972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18790 SUBER RD",
"city": "SIDNEY",
"state": "OH",
"postal_code": "453658785",
"telephone_number": "937-606-1158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18790 SUBER RD",
"city": "SIDNEY",
"state": "OH",
"postal_code": "453658785",
"telephone_number": "937-606-1158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAMISON",
"first_name": "JUSTIN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-05-31",
"last_updated": "2024-05-31",
"certification_date": "2024-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "171WH0202X",
"taxonomy_group": "",
"desc": "Contractor, Home Modifications",
"state": null,
"license": null,
"primary": true
},
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sidney, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 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.