Individual provider Active NPI

Jermetra Conway

  • Contractor
  • Columbus, OH
National Provider Identifier
1548969587
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
Practice address
3269 Burdett CT
Columbus, OH 43232-5961
Phone
(614) 302-6445
NPI assigned
Feb 28, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

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

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X
Child Intellectual and/or Developmental Disabilities Respite Care 385HR2060X
Home Health Aide 374U00000X
Homemaker 376J00000X
Respite Care 385H00000X
Child Mental Illness Respite Care 385HR2055X
Case Manager/Care Coordinator 171M00000X
Child Physical Disabilities Respite Care 385HR2065X
Contractor 171W00000X Primary

Addresses

Primary practice location

3269 Burdett CT
Columbus, OH 43232-5961

Mailing address

3269 Burdett CT
Columbus, OH 43232-5961
Phone (614) 302-6445

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Undefined Non-Physician Type (Specify)
Education
Other, 1999
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

733 E Dublin Granville Rd
Suite 206
Columbus, OH 43229-3200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pure Angels, LLC Current Accepting new patients
Pure Angels Lab Services, LLC Current Accepting new patients
Pha Lab Services PastSince Jan 1, 2022 Accepting new patients

Organizations & group practices 3

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": "1677542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677542400000",
    "number": "1548969587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3269 BURDETT CT",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432325961",
            "telephone_number": "614-302-6445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3269 BURDETT CT",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432325961",
            "telephone_number": "614-302-6445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONWAY",
        "first_name": "JERMETRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-28",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2055X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Mental Illness, Child",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2065X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Physical Disabilities, Child",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.