Katrina Jean Canada, INDEPENDENT PROVIDER

Primary specialty

HomemakerTaxonomy code 376J00000X

License

5101502 Issued in OH

Practice address

288 Rose Ave
Marion, OH 43302-2844

Phone

(419) 617-2190

NPI assigned

Sep 15, 2020

Last updated

Feb 17, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1600128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708128000000",
    "number": "1447865548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "288 ROSE AVE",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433022844",
            "telephone_number": "740-692-5424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "288 ROSE AVE",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433022844",
            "telephone_number": "419-617-2190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANADA",
        "first_name": "KATRINA",
        "middle_name": "JEAN",
        "credential": "INDEPENDENT PROVIDER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-15",
        "last_updated": "2024-02-17",
        "certification_date": "2024-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": "OH",
            "license": "5101502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0400577",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Homemaker in Marion, OH
• Providers in Marion, OH by specialty
• Homemaker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 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.

Verify at the official NPI Registry.