Active NPI
Chenita Dawn Gillum
- Homemaker
- Mansfield, OH
National Provider Identifier
1639399215
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Homemaker
- Practice address
- 260 E Cook Rd
Apt 109
Mansfield, OH 44907 - Phone
- (419) 756-5137
- NPI assigned
- Apr 26, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Homemaker | 376J00000X | Primary |
Addresses
Primary practice location
260 E Cook Rd
Apt 109
Mansfield, OH 44907
Mailing address
768 McPherson St
Mansfield, OH 44903-7139
Phone (567) 241-3051
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2705228 | Other | OH | IP |
| 400552411106 | Other | OH | STNA |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693353600000",
"number": "1639399215",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "768 MCPHERSON ST",
"city": "MANSFIELD",
"state": "OH",
"postal_code": "449037139",
"telephone_number": "567-241-3051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "260 E COOK RD",
"address_2": "APT 109",
"city": "MANSFIELD",
"state": "OH",
"postal_code": "44907",
"telephone_number": "419-756-5137"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLUM",
"first_name": "CHENITA",
"middle_name": "DAWN",
"name_prefix": "Miss",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-26",
"last_updated": "2023-08-30",
"certification_date": "2023-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "376J00000X",
"taxonomy_group": "",
"desc": "Homemaker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IP",
"identifier": "2705228",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STNA",
"identifier": "400552411106",
"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 Aug 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.