Individual provider Active NPI

Melinda Lee Kauffman, LPN, LCDCII

  • Licensed Practical Nurse
  • Wooster, OH
National Provider Identifier
1477891778
Registry record updated Nov 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN099079MIV Issued in OH
Practice address
104 Spink St
Wooster, OH 44691-3652
Phone
(330) 264-8498
Fax
(330) 264-3777
NPI assigned
Jan 21, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Licensed Practical Nurse 164W00000X PN099079MIV OH Primary

Addresses

Primary practice location

104 Spink St
Wooster, OH 44691-3652

Mailing address

104 Spink St
Wooster, OH 44691-3652
Phone (330) 264-8498

Other identifiers 1

IdentifierTypeStateIssuer
2864271MedicaidOH

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

LicenseStateTypeSpecialty
PN099079MIVOHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1358726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637193600000",
    "number": "1477891778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 SPINK ST",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446913652",
            "telephone_number": "330-264-8498",
            "fax_number": "330-264-3777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 SPINK ST",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446913652",
            "telephone_number": "330-264-8498",
            "fax_number": "330-264-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUFFMAN",
        "first_name": "MELINDA",
        "middle_name": "LEE",
        "credential": "LPN, LCDCII",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-21",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN099079MIV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2864271",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wooster, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2021; 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.