Individual provider Active NPI

Susan J. Kaminski, R.N.

  • Home Health Registered Nurse
  • Medina, OH
National Provider Identifier
1619179371
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
175230 Issued in OH
Practice address
521 Harding St
Medina, OH 44256-1641
Phone
(330) 725-3062
NPI assigned
Jun 4, 2007
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 Nurse 163WH0200X 175230 OH Primary

Addresses

Primary practice location

521 Harding St
Medina, OH 44256-1641

Mailing address

521 Harding St
Medina, OH 44256-1641
Phone (330) 725-3062

Other identifiers 1

IdentifierTypeStateIssuer
2617976MedicaidOH

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
175230OHMDHome Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1619179371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 HARDING ST",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442561641",
            "telephone_number": "330-725-3062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 HARDING ST",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442561641",
            "telephone_number": "330-725-3062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMINSKI",
        "first_name": "SUSAN",
        "middle_name": "J.",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-04",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "OH",
            "license": "175230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2617976",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medina, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.