Mariah Lynn Newman
Individual provider Active NPI Attendant Care Provider · Carmi, IL
NPI 1700664992 · NPPES record last updated Sep 19, 2023
Key facts
- NPI
- 1700664992
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Attendant Care Provider 3747A0650X
- Practice address
- 406 James Ave
Carmi, IL 62821-2352 - Phone
- (618) 308-7089
- NPI assigned
- Sep 19, 2023
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Attendant Care Provider | 3747A0650X | Yes |
Addresses
Primary practice location
406 James Ave
Carmi, IL 62821-2352
Mailing address
406 James Ave
Carmi, IL 62821-2352
Phone (618) 308-7089
NPI Registry JSON
{
"created_epoch": "1695081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695081600000",
"number": "1700664992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "406 JAMES AVE",
"city": "CARMI",
"state": "IL",
"postal_code": "628212352",
"telephone_number": "618-308-7089"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "406 JAMES AVE",
"city": "CARMI",
"state": "IL",
"postal_code": "628212352",
"telephone_number": "618-308-7089"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEWMAN",
"first_name": "MARIAH",
"middle_name": "LYNN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-09-19",
"last_updated": "2023-09-19",
"certification_date": "2023-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "3747A0650X",
"taxonomy_group": "",
"desc": "Technician, Attendant Care Provider",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 19, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.