Active NPI
Jennifer Marie Atwell, CERTIFIED PROVIDER
- Home Health Agency
- Mansfield, OH
National Provider Identifier
1548504160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 2971324
- Practice address
- 85 W Raleigh Ave
Mansfield, OH 44907-1335 - Phone
- (567) 241-3618
- Fax
- (419) 775-5487
- NPI assigned
- Nov 20, 2012
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmentally Disabled Services Day Training Agency | 251C00000X | 2971324 | OH | |
| Home Health Agency | 251E00000X | 2971324 | OH | Primary |
| Nursing Care Agency | 251J00000X | 2971324 | OH |
Addresses
Primary practice location
85 W Raleigh Ave
Mansfield, OH 44907-1335
Mailing address
85 W Raleigh Ave
Mansfield, OH 44907-1335
Phone (567) 241-3618
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7002406 | Other | OH | OHIO DEPARTMENT OF DEVELOPMENTAL DISABILITIES CONTRACT NUMBER |
| 2971324 | Medicaid | OH |
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 |
|---|---|---|---|
| 2971324 | OH | MD | Developmentally Disabled Services Day Training Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1353369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353369600000",
"number": "1548504160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "85 W RALEIGH AVE",
"city": "MANSFIELD",
"state": "OH",
"postal_code": "449071335",
"telephone_number": "567-241-3618",
"fax_number": "419-775-5487"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "85 W RALEIGH AVE",
"city": "MANSFIELD",
"state": "OH",
"postal_code": "449071335",
"telephone_number": "567-241-3618",
"fax_number": "419-775-5487"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ATWELL",
"first_name": "JENNIFER",
"middle_name": "MARIE",
"name_prefix": "Miss",
"credential": "CERTIFIED PROVIDER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-11-20",
"last_updated": "2012-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "251C00000X",
"taxonomy_group": "",
"desc": "Day Training, Developmentally Disabled Services",
"state": "OH",
"license": "2971324",
"primary": false
},
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "OH",
"license": "2971324",
"primary": true
},
{
"code": "251J00000X",
"taxonomy_group": "",
"desc": "Nursing Care",
"state": "OH",
"license": "2971324",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OHIO DEPARTMENT OF DEVELOPMENTAL DISABILITIES CONTRACT NUMBER",
"identifier": "7002406",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2971324",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mansfield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.