Signature Health Services-Mansfield, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

SIGNATURE HEALTH SERVICES-MANSFIELD, LLC

Practice address

1092 Lexington Ave
Mansfield, OH 44907-2250

Phone

(419) 589-5921

Fax

(419) 589-5871

NPI assigned

Mar 19, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Jack D Goldsberry

Title

Coo

Phone

(330) 666-3810

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236816000000",
    "number": "1780708404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1092 LEXINGTON AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449072250",
            "telephone_number": "419-589-5921",
            "fax_number": "419-589-5871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1092 LEXINGTON AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449072250",
            "telephone_number": "419-589-5921",
            "fax_number": "419-589-5871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIGNATURE HEALTH SERVICES-MANSFIELD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2009-03-12",
        "status": "A",
        "authorized_official_last_name": "GOLDSBERRY",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "330-666-3810",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2896059",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelley L. Shupp
• Alyssa Sickle, MD
• Siraj A Siddiqui, MD
• Rebecca Siedel
• Anissa Danielle Siefert, M.O.T., OTR/L
• Silver Birch of Mansfield LLC
• Ashley N. Simmons, COTA/L
• Wendell Simmons
• Constance Simms
• Joanna Simonson

• All providers in Mansfield, OH
• Home Health Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2009; 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.