Individual provider Active NPI

Kimberly Sue Costlow

  • Homemaker
  • Akron, OH
National Provider Identifier
1851992382
Registry record updated Nov 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
HomemakerTaxonomy code 376J00000X
License
7712130 Issued in OH
Practice address
1467 Fawler Ave
Akron, OH 44314-1809
Phone
(330) 848-1012
NPI assigned
Nov 2, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Homemaker 376J00000X 7712130 OH Primary

Addresses

Primary practice location

1467 Fawler Ave
Akron, OH 44314-1809

Mailing address

1467 Fawler Ave
Akron, OH 44314-1809
Phone (330) 848-1012

Other identifiers 1

IdentifierTypeStateIssuer
7712130MedicaidOH

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
7712130OHMDHomemaker

NPI Registry JSON

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

{
    "created_epoch": "1604275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604275200000",
    "number": "1851992382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1467 FAWLER AVE",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443141809",
            "telephone_number": "330-848-1012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1467 FAWLER AVE",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443141809",
            "telephone_number": "330-848-1012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTLOW",
        "first_name": "KIMBERLY",
        "middle_name": "SUE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-02",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": "OH",
            "license": "7712130",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7712130",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2020; 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.