Active NPI
Visiting Nurse Extra Care
- Home Health Agency
- Maumee, OH
National Provider Identifier
1699760363
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- VISITING NURSE EXTRA CARE
- Practice address
- 383 W Dussel Dr
Maumee, OH 43537-1632 - Phone
- (419) 897-2800
- Fax
- (419) 897-2810
- NPI assigned
- Sep 19, 2005
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Gladeen Alice Roberts, PH.D.
- Title
- President
- Phone
- (419) 291-7847
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | NU | Primary |
Addresses
Primary practice location
383 W Dussel Dr
Maumee, OH 43537-1632
Mailing address
383 W Dussel Dr
Maumee, OH 43537-1632
Phone (419) 897-2800
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0865158 | Medicaid | OH | |
| 141096 | Other | MI | TRINITY HEALTH PLANS |
| 0183117 | Medicaid | OH | |
| 141096 | Other | MI | CARE CHOICES |
| 4210534 | Medicaid | MI |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127088000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1699760363",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "383 W DUSSEL DR",
"city": "MAUMEE",
"state": "OH",
"postal_code": "435371632",
"telephone_number": "419-897-2800",
"fax_number": "419-897-2810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "383 W DUSSEL DR",
"city": "MAUMEE",
"state": "OH",
"postal_code": "435371632",
"telephone_number": "419-897-2800",
"fax_number": "419-897-2810"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VISITING NURSE EXTRA CARE",
"organizational_subpart": "NO",
"enumeration_date": "2005-09-19",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "ROBERTS",
"authorized_official_first_name": "GLADEEN",
"authorized_official_middle_name": "ALICE",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "419-291-7847",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PH.D."
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0865158",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRINITY HEALTH PLANS",
"identifier": "141096",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0183117",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARE CHOICES",
"identifier": "141096",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4210534",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Maumee, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.