NPIMap

Organization Active NPI

Heart on Ice

  • Adult Day Care Clinic/Center
  • Oregon, OH
National Provider Identifier
1952156739
Registry record updated Apr 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
Legal business name
HEART ON ICE
Doing business as
Heart On Ice
Practice address
4736 N Teal LN
Oregon, OH 43616-1674
Phone
(419) 360-7994
NPI assigned
Apr 23, 2024
Last updated
Apr 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2024

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

Authorized official

Name
Mr. Feisal Crumby Jr.NPI 1609627439
Title
Doo
Phone
(419) 360-7994

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X NU
Adult Day Care Clinic/Center 261QA0600X NU Primary
Non-emergency Medical Transport (VAN) 343900000X NU
Private Vehicle 347C00000X NU
In Home Supportive Care Agency 253Z00000X NU

Addresses

Primary practice location

4736 N Teal LN
Oregon, OH 43616-1674

Mailing address

4736 N Teal LN
Oregon, OH 43616-1674
Phone (419) 360-7994

Other names 1

  • Heart On Ice Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1713830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713830400000",
    "number": "1952156739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4736 N TEAL LN",
            "city": "OREGON",
            "state": "OH",
            "postal_code": "436161674",
            "telephone_number": "419-360-7994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4736 N TEAL LN",
            "city": "OREGON",
            "state": "OH",
            "postal_code": "436161674",
            "telephone_number": "419-360-7994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEART ON ICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-23",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A",
        "authorized_official_last_name": "CRUMBY",
        "authorized_official_first_name": "FEISAL",
        "authorized_official_title_or_position": "DOO",
        "authorized_official_telephone_number": "419-360-7994",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heart On Ice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oregon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; 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.