Individual provider Active NPI

Susan Elizabeth Collar

  • Personal Care Attendant
  • Englewood, OH
National Provider Identifier
1639749708
Registry record updated Jun 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Care AttendantTaxonomy code 3747P1801X
Practice address
305 Pauly Dr
Englewood, OH 45315-9650
Phone
(937) 232-5174
NPI assigned
Jun 30, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X Primary

Addresses

Primary practice location

305 Pauly Dr
Englewood, OH 45315-9650

Mailing address

305 Pauly Dr
Englewood, OH 45315-9650
Phone (937) 232-5174

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": "1625011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1639749708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 PAULY DR",
            "city": "ENGLEWOOD",
            "state": "OH",
            "postal_code": "453159650",
            "telephone_number": "937-232-5174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 PAULY DR",
            "city": "ENGLEWOOD",
            "state": "OH",
            "postal_code": "453159650",
            "telephone_number": "937-232-5174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLAR",
        "first_name": "SUSAN",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-30",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; 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.