Individual provider Active NPI

Amy Janeen Kanellis

  • Licensed Practical Nurse
  • Toledo, OH
National Provider Identifier
1841571650
Registry record updated Sep 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN114378 Issued in OH
Practice address
2726 Ralphwood Dr
Toledo, OH 43613-1228
Phone
(419) 902-2402
NPI assigned
Sep 7, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN114378 OH Primary

Addresses

Primary practice location

2726 Ralphwood Dr
Toledo, OH 43613-1228

Mailing address

2726 Ralphwood Dr
Toledo, OH 43613-1228
Phone (419) 902-2402

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
PN114378OHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1315353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315353600000",
    "number": "1841571650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2726 RALPHWOOD DR",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436131228",
            "telephone_number": "419-902-2402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2726 RALPHWOOD DR",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436131228",
            "telephone_number": "419-902-2402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANELLIS",
        "first_name": "AMY",
        "middle_name": "JANEEN",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-07",
        "last_updated": "2011-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN114378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2011; 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.