Individual provider Active NPI

Tina S Levan, REGISTERED NURSE

  • Home Health Registered Nurse
  • Marysville, OH
National Provider Identifier
1497232334
Registry record updated Jul 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
RN359667 Issued in OH
Practice address
16501 Square Dr
Marysville, OH 43040-9557
Phone
(937) 738-6999
NPI assigned
Jul 24, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WH0200X RN359667 OH Primary

Addresses

Primary practice location

16501 Square Dr
Marysville, OH 43040-9557

Mailing address

16501 Square Dr
Marysville, OH 43040-9557
Phone (937) 738-6999

Other identifiers 1

IdentifierTypeStateIssuer
82-3753384MedicaidOH

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
RN359667OHMDHome Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Home Care Collective LLC Current Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1532390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532390400000",
    "number": "1497232334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16501 SQUARE DR",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "430409557",
            "telephone_number": "937-738-6999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16501 SQUARE DR",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "430409557",
            "telephone_number": "937-738-6999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVAN",
        "first_name": "TINA",
        "middle_name": "S",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-24",
        "last_updated": "2018-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Home Health",
            "state": "OH",
            "license": "RN359667",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "82-3753384",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marysville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2018; 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.