Individual provider Active NPI

Deloris Miller

  • Child Intellectual and/or Developmental Disabilities Respite Care
  • Sandusky, OH
National Provider Identifier
1811397391
Registry record updated Sep 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child Intellectual and/or Developmental Disabilities Respite CareTaxonomy code 385HR2060X
License
147213 Issued in OH
Practice address
5303 Columbus Ave
Sandusky, OH 44870-8330
Phone
(419) 984-0240
NPI assigned
Sep 3, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child Intellectual and/or Developmental Disabilities Respite Care 385HR2060X 147213 OH Primary

Addresses

Primary practice location

5303 Columbus Ave
Sandusky, OH 44870-8330

Mailing address

5303 Columbus Ave
Sandusky, OH 44870-8330
Phone (419) 984-0240

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
147213OHMDChild Intellectual and/or Developmental Disabilities Respite Care

NPI Registry JSON

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

{
    "created_epoch": "1409702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409702400000",
    "number": "1811397391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5303 COLUMBUS AVE",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448708330",
            "telephone_number": "419-984-0240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5303 COLUMBUS AVE",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448708330",
            "telephone_number": "419-984-0240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "DELORIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-03",
        "last_updated": "2014-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": "OH",
            "license": "147213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandusky, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2014; 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.