Individual provider Active NPI

Susan Marie Stevens

  • Homemaker
  • Van Wert, OH
National Provider Identifier
1881290484
Registry record updated Dec 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
HomemakerTaxonomy code 376J00000X
Practice address
233 Thistlewood CT Apt 225
Van Wert, OH 45891-1382
Phone
(419) 236-1424
NPI assigned
Dec 9, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2020

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X
In Home Supportive Care Agency 253Z00000X
Private Vehicle 347C00000X
Personal Care Attendant 3747P1801X
Home Health Aide 374U00000X
Child Intellectual and/or Developmental Disabilities Respite Care 385HR2060X
Homemaker 376J00000X Primary

Addresses

Primary practice location

233 Thistlewood CT Apt 225
Van Wert, OH 45891-1382

Mailing address

16511 Galvin Rd
Van Wert, OH 45891-8647
Phone (419) 236-1424

Other practice location 1

16511 Galvin Rd
Van Wert, OH 45891-8647
Phone (419) 236-1424

Other identifiers 1

IdentifierTypeStateIssuer
0266563MedicaidOH

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": "1607472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1881290484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16511 GALVIN RD",
            "city": "VAN WERT",
            "state": "OH",
            "postal_code": "458918647",
            "telephone_number": "419-236-1424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 THISTLEWOOD CT APT 225",
            "city": "VAN WERT",
            "state": "OH",
            "postal_code": "458911382",
            "telephone_number": "419-236-1424"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16511 Galvin Rd",
            "address_purpose": "LOCATION",
            "city": "Van Wert",
            "state": "OH",
            "postal_code": "458918647",
            "country_code": "US",
            "telephone_number": "419-236-1424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-09",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0266563",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Wert, OH

Sources for this page

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