Eleonora Tatashadze, PROVIDER

Primary specialty

Home Modifications ContractorTaxonomy code 171WH0202X

License

4203630 Issued in OH

Practice address

6613 Finegan Dr
Dayton, OH 45424-7112

Phone

(860) 726-6200

NPI assigned

Apr 28, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Eleonora Tatashadze Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Rocky Hill Adult Day Center and in Home Care LLC

  • Home Health Agency
  • Rocky Hill, CT
  • NPI 1972894657
  NPD Authorized official

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

{
    "created_epoch": "1303948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608768000000",
    "number": "1639460371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6613 FINEGAN DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454247112",
            "telephone_number": "860-726-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6613 FINEGAN DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454247112",
            "telephone_number": "860-726-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATASHADZE",
        "first_name": "ELEONORA",
        "credential": "PROVIDER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-28",
        "last_updated": "2020-12-24",
        "certification_date": "2020-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171WH0202X",
            "taxonomy_group": "",
            "desc": "Contractor, Home Modifications",
            "state": "CT",
            "license": "0000493",
            "primary": false
        },
        {
            "code": "171WH0202X",
            "taxonomy_group": "",
            "desc": "Contractor, Home Modifications",
            "state": "OH",
            "license": "4203630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF OHIO CERTIFICATE",
            "identifier": "4203630",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELEONORA",
            "last_name": "TATASHADZE",
            "credential": "PROVIDER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Leatrice Tartt
• Abigail F Tarwater
• Hooman Tashakor, D.C
• Julie Tasker, LPN
• Patricia Catlin Tatarzycki, LISW-S
• Erika Renee Tate
• Katherine Tate, PA-C
• Madison A Tate, PA-C
• Miranda Tatom
• Molly A Tatum, D.O.

• Home Modifications Contractor in Dayton, OH
• Providers in Dayton, OH by specialty
• Home Modifications Contractor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2020; 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.