Individual provider Active NPI

Rhanda Fillmore, CT

  • Counselor
  • Lorain, OH
National Provider Identifier
1639780455
Registry record updated Oct 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
C.2204371-TRNE Issued in OH
Practice address
Nord Center 6140 S Broadway
Lorain, OH 44053-3891
Phone
(440) 233-7232
Fax
(440) 204-4315
NPI assigned
Aug 14, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X OH
Community Health Worker 172V00000X OH
Counselor 101Y00000X C.2204371-TRNE OH Primary

Addresses

Primary practice location

Nord Center 6140 S Broadway
Lorain, OH 44053-3891

Mailing address

6140 S Broadway
Lorain, OH 44053-3891
Phone (440) 233-7232

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C.2204371-TRNEOHMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1597363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666828800000",
    "number": "1639780455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6140 S BROADWAY",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440533891",
            "telephone_number": "440-233-7232",
            "fax_number": "440-204-4315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NORD CENTER 6140 S BROADWAY",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440533891",
            "telephone_number": "440-233-7232",
            "fax_number": "440-204-4315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FILLMORE",
        "first_name": "RHANDA",
        "credential": "CT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-14",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "C.2204371-TRNE",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lorain, OH

Sources for this page

Verify at the official NPI Registry.