Individual provider Active NPI

Christina Marie Grezlik, STNA

  • Home Health Aide
  • Hudson, OH
National Provider Identifier
1891811824
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
400013170801 Issued in OH
Practice address
5537 Hudson Dr
Hudson, OH 44236-3743
Phone
(330) 281-1309
Fax
(330) 294-0802
NPI assigned
Mar 21, 2007
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X 400013170801 OH Primary

Addresses

Primary practice location

5537 Hudson Dr
Hudson, OH 44236-3743

Mailing address

5537 Hudson Dr
Hudson, OH 44236-3743
Phone (330) 281-1309

Other identifiers 1

IdentifierTypeStateIssuer
2472131MedicaidOH

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
400013170801OHMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1891811824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5537 HUDSON DR",
            "city": "HUDSON",
            "state": "OH",
            "postal_code": "442363743",
            "telephone_number": "330-281-1309",
            "fax_number": "330-294-0802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5537 HUDSON DR",
            "city": "HUDSON",
            "state": "OH",
            "postal_code": "442363743",
            "telephone_number": "330-281-1309",
            "fax_number": "330-294-0802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREZLIK",
        "first_name": "CHRISTINA",
        "middle_name": "MARIE",
        "credential": "STNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "OH",
            "license": "400013170801",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2472131",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.