Katrina Laverne Gardner, INDEPENDANT PROVIDER

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

1831901 Issued in OH

Practice address

120 Ruth Ellen Dr Apt H311
Richmond HTS, OH 44143-1028

Phone

(216) 240-7216

Fax

(216) 472-8530

NPI assigned

Nov 9, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1667952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667952000000",
    "number": "1811605744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 RUTH ELLEN DR APT H311",
            "city": "RICHMOND HTS",
            "state": "OH",
            "postal_code": "441431028",
            "telephone_number": "216-240-7216",
            "fax_number": "216-472-8530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 RUTH ELLEN DR APT H311",
            "city": "RICHMOND HTS",
            "state": "OH",
            "postal_code": "441431028",
            "telephone_number": "216-240-7216",
            "fax_number": "216-472-8530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "KATRINA",
        "middle_name": "LAVERNE",
        "credential": "INDEPENDANT PROVIDER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-09",
        "last_updated": "2022-11-09",
        "certification_date": "2022-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "OH",
            "license": "1831901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• In Home Supportive Care Agency in Richmond HTS, OH
• Providers in Richmond HTS, OH by specialty
• In Home Supportive Care Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2022; 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.