Individual provider Active NPI

Terry Ray Rooney

  • Nurse's Aide
  • Logan, OH
National Provider Identifier
1700566031
Registry record updated Jul 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
402040030218 Issued in OH
Practice address
789 Wyandotte Ave
Logan, OH 43138-1878
Phone
(740) 279-6162
NPI assigned
Jul 21, 2023
Last updated
Jul 21, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X
Nurse's Aide 376K00000X 402040030218 OH Primary

Addresses

Primary practice location

789 Wyandotte Ave
Logan, OH 43138-1878

Mailing address

789 Wyandotte Ave
Logan, OH 43138-1878
Phone (740) 279-6162

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
402040030218OHMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1689897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689897600000",
    "number": "1700566031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "789 WYANDOTTE AVE",
            "city": "LOGAN",
            "state": "OH",
            "postal_code": "431381878",
            "telephone_number": "740-279-6162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "789 WYANDOTTE AVE",
            "city": "LOGAN",
            "state": "OH",
            "postal_code": "431381878",
            "telephone_number": "740-279-6162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROONEY",
        "first_name": "TERRY",
        "middle_name": "RAY",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-21",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "OH",
            "license": "402040030218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2023; 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.