Susan Amiott
Individual provider Active NPI Attendant Care Provider · Willoughby, OH
NPI 1881297612 · NPPES record last updated Nov 16, 2020
Key facts
- NPI
- 1881297612
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Attendant Care Provider 3747A0650X
- License
- 4301222 (OH)
- Practice address
- 1245 Leeward LN
Willoughby, OH 44094-7007 - Phone
- (440) 376-5989
- NPI assigned
- Nov 16, 2020
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301222 | OH | MD | Attendant Care Provider |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Attendant Care Provider | 3747A0650X | 4301222 | OH | Yes |
Addresses
Primary practice location
1245 Leeward LN
Willoughby, OH 44094-7007
Mailing address
1245 Leeward LN
Willoughby, OH 44094-7007
Phone (440) 376-5989
NPI Registry JSON
{
"created_epoch": "1605484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605484800000",
"number": "1881297612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1245 LEEWARD LN",
"city": "WILLOUGHBY",
"state": "OH",
"postal_code": "440947007",
"telephone_number": "440-376-5989"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1245 LEEWARD LN",
"city": "WILLOUGHBY",
"state": "OH",
"postal_code": "440947007",
"telephone_number": "440-376-5989"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMIOTT",
"first_name": "SUSAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-16",
"last_updated": "2020-11-16",
"certification_date": "2020-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "3747A0650X",
"taxonomy_group": "",
"desc": "Technician, Attendant Care Provider",
"state": "OH",
"license": "4301222",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 16, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.