Individual provider Active NPI

Bertha M Munford, HOMECARE PROVIDER

  • Home Health Agency
  • Canton, OH
National Provider Identifier
1780219246
Registry record updated Mar 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
2921744 Issued in OH
Practice address
203 Raff Rd NW
Canton, OH 44708-5634
Phone
(330) 809-2339
NPI assigned
Mar 5, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 2921744 OH Primary

Addresses

Primary practice location

203 Raff Rd NW
Canton, OH 44708-5634

Mailing address

203 Raff Rd NW
Canton, OH 44708-5634
Phone (330) 809-2339

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
2921744OHMDHome Health Agency

NPI Registry JSON

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

{
    "created_epoch": "1583366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583366400000",
    "number": "1780219246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 RAFF RD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447085634",
            "telephone_number": "330-809-2339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 RAFF RD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447085634",
            "telephone_number": "330-809-2339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNFORD",
        "first_name": "BERTHA",
        "middle_name": "M",
        "credential": "HOMECARE PROVIDER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-05",
        "last_updated": "2020-03-05",
        "certification_date": "2020-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "OH",
            "license": "2921744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2020; 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.