Active NPI
Marie Willoughby
- Home Health Aide
- Sardinia, OH
National Provider Identifier
1720106073
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- License
- 2377511
- Practice address
- 9858 Fincastle Winchester Rd
Sardinia, OH 45171-9357 - Phone
- (937) 695-0400
- NPI assigned
- Mar 26, 2007
- Last updated
- Jul 9, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | 2377511 | OH | Primary |
Addresses
Primary practice location
9858 Fincastle Winchester Rd
Sardinia, OH 45171-9357
Mailing address
9858 Fincastle Winchester Rd
Sardinia, OH 45171-9357
Phone (937) 695-0400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2377511 | Medicaid | OH |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2377511 | OH | MD | Home Health Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1720106073",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9858 FINCASTLE WINCHESTER RD",
"city": "SARDINIA",
"state": "OH",
"postal_code": "451719357",
"telephone_number": "937-695-0400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9858 FINCASTLE WINCHESTER RD",
"city": "SARDINIA",
"state": "OH",
"postal_code": "451719357",
"telephone_number": "937-695-0400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLOUGHBY",
"first_name": "MARIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-26",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "OH",
"license": "2377511",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2377511",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sardinia, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.