Active NPI
Jermetra Conway
- Contractor
- Columbus, OH
National Provider Identifier
1548969587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 9
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pure Angels, LLC | Current | Accepting new patients | |
| Pure Angels Lab Services, LLC | Current | Accepting new patients | |
| Pha Lab Services | Past | 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.
-
- Clinical Medical Laboratory
- Columbus, OH
- NPI 1710830401
-
- Home Health Agency
- Columbus, OH
- NPI 1356964282
-
- Health Service Clinic/Center
- Columbus, OH
- NPI 1629738091
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.