Individual provider Active NPI

Mia Lea Patterson

  • Personal Care Attendant
  • Gallipolis, OH
National Provider Identifier
1821661687
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Care AttendantTaxonomy code 3747P1801X
Practice address
102 Burnett Ext
Gallipolis, OH 45631-1988
Phone
(740) 612-0399
NPI assigned
Jul 20, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X Primary

Addresses

Primary practice location

102 Burnett Ext
Gallipolis, OH 45631-1988

Mailing address

102 Burnett Ext
Gallipolis, OH 45631-1988
Phone (740) 612-0399

Other identifiers 1

IdentifierTypeStateIssuer
0409225MedicaidOH

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

NPI Registry JSON

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

{
    "created_epoch": "1626739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1821661687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 BURNETT EXT",
            "city": "GALLIPOLIS",
            "state": "OH",
            "postal_code": "456311988",
            "telephone_number": "740-612-0399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 BURNETT EXT",
            "city": "GALLIPOLIS",
            "state": "OH",
            "postal_code": "456311988",
            "telephone_number": "740-612-0399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "MIA",
        "middle_name": "LEA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-20",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0409225",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallipolis, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; 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.