Bruce Cowin Carter

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

1301040 Issued in OH

Practice address

4096 Dela Palma Rd
Williamsburg, OH 45176-9712

Phone

(513) 724-7448

NPI assigned

Nov 30, 2020

Last updated

Nov 30, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1606694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1649874678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 646",
            "city": "WILLIAMSBURG",
            "state": "OH",
            "postal_code": "451760646",
            "telephone_number": "513-724-7448",
            "fax_number": "513-724-1174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4096 DELA PALMA RD",
            "city": "WILLIAMSBURG",
            "state": "OH",
            "postal_code": "451769712",
            "telephone_number": "513-724-7448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COWIN CARTER",
        "first_name": "BRUCE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-30",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "OH",
            "license": "1301040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2504310",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexandrea Nichole Click
• Aimee Jean Cooper, B.S.W., L.S.W.
• Tina Cooper
• Tabitha Michelle Courts
• Tanya Michelle Courts
• Michell Dean
• Delores Keith, Ibclc
• Denise a. Ferree
• Sahara Dawn Dorsey, BC-FNP
• Brenda K Durham

• Assisted Living Facility in Williamsburg, OH
• Providers in Williamsburg, OH by specialty
• Assisted Living Facility in Ohio

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