Active NPI
Patrice Jordan
- Home Health Aide
- Cleveland, OH
National Provider Identifier
1750075107
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- Practice address
- 4846 Lee Rd
Cleveland, OH 44128-3822 - Phone
- (440) 503-0965
- NPI assigned
- Jun 7, 2023
- 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 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Meals Provider | 174200000X | OH | ||
| Chore Provider | 372500000X | |||
| Driver | 172A00000X | SW766515 | OH | |
| Homemaker | 376J00000X | OH | ||
| Respite Care | 385H00000X | OH | ||
| Child Intellectual and/or Developmental Disabilities Respite Care | 385HR2060X | |||
| Home Health Aide | 374U00000X | Primary |
Addresses
Primary practice location
4846 Lee Rd
Cleveland, OH 44128-3822
Mailing address
4846 Lee Rd
Cleveland, OH 44128-3822
Phone (440) 503-0965
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 |
|---|---|---|---|
| SW766515 | OH | MD | Driver |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686787200000",
"number": "1750075107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4846 LEE RD",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441283822",
"telephone_number": "440-503-0965"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4846 LEE RD",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441283822",
"telephone_number": "440-503-0965"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "PATRICE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-06-07",
"last_updated": "2023-06-15",
"certification_date": "2023-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "174200000X",
"taxonomy_group": "",
"desc": "Meals",
"state": "OH",
"license": null,
"primary": false
},
{
"code": "372500000X",
"taxonomy_group": "",
"desc": "Chore Provider",
"state": null,
"license": null,
"primary": false
},
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "OH",
"license": "SW766515",
"primary": false
},
{
"code": "376J00000X",
"taxonomy_group": "",
"desc": "Homemaker",
"state": "OH",
"license": null,
"primary": false
},
{
"code": "385H00000X",
"taxonomy_group": "",
"desc": "Respite Care",
"state": "OH",
"license": null,
"primary": false
},
{
"code": "385HR2060X",
"taxonomy_group": "",
"desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
"state": null,
"license": null,
"primary": false
},
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.