Individual provider Active NPI

Brandy L Davis, STNA

  • Home Health Aide
  • Marion, OH
National Provider Identifier
1770845505
Registry record updated Jun 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
401185241210 Issued in OH
Practice address
292 1/2 Hane Ave
Marion, OH 43302-5368
Phone
(740) 244-4172
NPI assigned
Jun 7, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X 401185241210 OH Primary
Nurse's Aide 376K00000X 401185241210 OH
Student in an Organized Health Care Education/Training Program 390200000X 401185241210 OH

Addresses

Primary practice location

292 1/2 Hane Ave
Marion, OH 43302-5368

Mailing address

292 1/2 Hane Ave
Marion, OH 43302-5368
Phone (740) 244-4172

Other identifiers 1

IdentifierTypeStateIssuer
401185241210OtherOHNURSE AID REGISTRY #

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
401185241210OHMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1339027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339027200000",
    "number": "1770845505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "292 1/2 HANE AVE",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433025368",
            "telephone_number": "740-244-4172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "292 1/2 HANE AVE",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433025368",
            "telephone_number": "740-244-4172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "BRANDY",
        "middle_name": "L",
        "credential": "STNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-07",
        "last_updated": "2012-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "OH",
            "license": "401185241210",
            "primary": true
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "OH",
            "license": "401185241210",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": "401185241210",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE AID REGISTRY #",
            "identifier": "401185241210",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2012; 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.