Individual provider Active NPI

Mary A Walker

  • Nurse's Aide
  • Cleveland, OH
National Provider Identifier
1760102362
Registry record updated Sep 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
401690870914 Issued in OH
Practice address
4132 Woodbridge Ave
Cleveland, OH 44109-5948
Phone
(216) 849-9736
NPI assigned
Sep 1, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X 401690870914 OH Primary

Addresses

Primary practice location

4132 Woodbridge Ave
Cleveland, OH 44109-5948

Mailing address

4132 Woodbridge Ave
Cleveland, OH 44109-5948
Phone (216) 849-9736

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL n/a

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
401690870914OHMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1661990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1760102362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4132 WOODBRIDGE AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441095948",
            "telephone_number": "216-849-9736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4132 WOODBRIDGE AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441095948",
            "telephone_number": "216-849-9736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "MARY",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-01",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "OH",
            "license": "401690870914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "n/a",
            "affiliation": "N",
            "address_1": "4132 Woodbridge Ave",
            "city": "Cleveland",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441095948",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Sep 1, 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.

Verify at the official NPI Registry.