Individual provider Active NPI

Jessica Boldt Hartson

  • Community Health Worker
  • Piqua, OH
National Provider Identifier
1689950776
Registry record updated Nov 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
141872 Issued in OH
Practice address
218 E Main St
Piqua, OH 45356-4038
Phone
(937) 451-7308
NPI assigned
Nov 2, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X 141872 OH Primary

Addresses

Primary practice location

218 E Main St
Piqua, OH 45356-4038

Mailing address

218 E Main St
Piqua, OH 45356-4038
Phone (937) 451-7308

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

State licenses

LicenseStateTypeSpecialty
141872OHMDCommunity Health Worker

NPI Registry JSON

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

{
    "created_epoch": "1320192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320192000000",
    "number": "1689950776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 E MAIN ST",
            "city": "PIQUA",
            "state": "OH",
            "postal_code": "453564038",
            "telephone_number": "937-451-7308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 E MAIN ST",
            "city": "PIQUA",
            "state": "OH",
            "postal_code": "453564038",
            "telephone_number": "937-451-7308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTSON",
        "first_name": "JESSICA",
        "middle_name": "BOLDT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-02",
        "last_updated": "2011-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "OH",
            "license": "141872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Piqua, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2011; 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.