Individual provider Active NPI

Sandra D Covarrubias

  • In Home Supportive Care Agency
  • Toledo, OH
National Provider Identifier
1639767544
Registry record updated Jan 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Practice address
433 Clark St
Toledo, OH 43605-2211
Phone
(419) 410-7633
NPI assigned
Jan 6, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X OH
Private Vehicle 347C00000X OH
Homemaker 376J00000X OH
In Home Supportive Care Agency 253Z00000X OH Primary

Addresses

Primary practice location

433 Clark St
Toledo, OH 43605-2211

Mailing address

PO Box 167301
Oregon, OH 43616-7301
Phone (419) 410-7633

Other identifiers 1

IdentifierTypeStateIssuer
0426164MedicaidOH

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": "1609891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609891200000",
    "number": "1639767544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 167301",
            "city": "OREGON",
            "state": "OH",
            "postal_code": "436167301",
            "telephone_number": "419-410-7633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 CLARK ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436052211",
            "telephone_number": "419-410-7633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COVARRUBIAS",
        "first_name": "SANDRA",
        "middle_name": "D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-06",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0426164",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 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.