Active NPI
Breanna Danielle Pogue
- Home Health Aide
- Trotwood, OH
National Provider Identifier
1740997659
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- License
- 602317750321
- Practice address
- 4767 Little Richmond Rd
Trotwood, OH 45426-3201 - Phone
- (937) 789-0884
- NPI assigned
- Oct 31, 2022
- Sex
- Male
- Sole proprietor
- No
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 | 602317750321 | OH | Primary |
Addresses
Primary practice location
4767 Little Richmond Rd
Trotwood, OH 45426-3201
Mailing address
4767 Little Richmond Rd
Trotwood, OH 45426-3201
Phone (937) 789-0884
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 |
|---|---|---|---|
| 602317750321 | OH | MD | Home Health Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1667174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667174400000",
"number": "1740997659",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4767 LITTLE RICHMOND RD",
"city": "TROTWOOD",
"state": "OH",
"postal_code": "454263201",
"telephone_number": "937-789-0884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4767 LITTLE RICHMOND RD",
"city": "TROTWOOD",
"state": "OH",
"postal_code": "454263201",
"telephone_number": "937-789-0884"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POGUE",
"first_name": "BREANNA",
"middle_name": "DANIELLE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-10-31",
"last_updated": "2022-10-31",
"certification_date": "2022-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "OH",
"license": "602317750321",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Trotwood, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.