Organization Active NPI

Custom Care NP Services

  • Family Nurse Practitioner
  • Delaware, OH
National Provider Identifier
1770857138
Registry record updated Oct 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
COA.07465-NP Issued in OH
Legal business name
CUSTOM CARE NP SERVICES
Practice address
513 Birchard Ave
Delaware, OH 43015-1103
Phone
(740) 272-7150
Fax
(740) 362-2524
NPI assigned
Mar 2, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2014

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

Authorized official

Name
Heather Lynne Howard, CNPNPI 1285603407
Title
Owner
Phone
(740) 272-7150

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X COA.07465-NP OH Primary

Addresses

Primary practice location

513 Birchard Ave
Delaware, OH 43015-1103

Mailing address

513 Birchard Ave
Delaware, OH 43015-1103
Phone (740) 272-7150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120522001165 OH Part B Supplier - Clinic/Group Practice 5991968372 Receives reassigned benefits from 1 practitioner
Practice locations: Columbus, OH

National Provider Directory

National Provider Directory

Locations

2270 Warrensburg Rd
Delaware, OH 43015
Phone (740) 272-7150

400 Barks Rd W
Marion, OH 43302
Phone (740) 387-1225

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1330646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413417600000",
    "number": "1770857138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 BIRCHARD AVE",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "430151103",
            "telephone_number": "740-272-7150",
            "fax_number": "740-362-2524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 BIRCHARD AVE",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "430151103",
            "telephone_number": "740-272-7150",
            "fax_number": "740-362-2524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM CARE NP SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-02",
        "last_updated": "2014-10-16",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "LYNNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "740-272-7150",
        "authorized_official_credential": "CNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA.07465-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delaware, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.