Active NPI
Edna Mae Nickson
- Home Health Agency
- Alliance, OH
National Provider Identifier
1942618541
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 2829505
- Practice address
- 537 E Columbia St
Alliance, OH 44601-2550 - Phone
- (330) 823-0465
- NPI assigned
- Jul 27, 2014
- Last updated
- Jul 27, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 2829505 | OH | Primary |
Addresses
Primary practice location
537 E Columbia St
Alliance, OH 44601-2550
Mailing address
537 E Columbia St
Alliance, OH 44601-2550
Phone (330) 823-0465
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2829505 | Medicaid | OH |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2829505 | OH | MD | Home Health Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1406419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406419200000",
"number": "1942618541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "537 E COLUMBIA ST",
"city": "ALLIANCE",
"state": "OH",
"postal_code": "446012550",
"telephone_number": "330-823-0465"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "537 E COLUMBIA ST",
"city": "ALLIANCE",
"state": "OH",
"postal_code": "446012550",
"telephone_number": "330-823-0465"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICKSON",
"first_name": "EDNA",
"middle_name": "MAE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-07-27",
"last_updated": "2014-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "OH",
"license": "2829505",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2829505",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Alliance, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.