Active NPI
Jacqueline Anna Marie Elliott
- Home Health Aide
- Barberton, OH
National Provider Identifier
1962615666
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- License
- 2272503
- Practice address
- 354 Frank Street
Barberton, OH 44203 - Phone
- (330) 848-5383
- NPI assigned
- May 8, 2007
- Sex
- Female
- Sole proprietor
- No
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 Aide | 374U00000X | 2272503 | OH | Primary |
Addresses
Primary practice location
354 Frank Street
Barberton, OH 44203
Mailing address
28 18TH Street NW
Barberton, OH 44203
Phone (330) 431-9321
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2272503 | 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 |
|---|---|---|---|
| 2272503 | OH | MD | Home Health Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962615666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28 18TH STREET NW",
"city": "BARBERTON",
"state": "OH",
"postal_code": "44203",
"telephone_number": "330-431-9321"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "354 FRANK STREET",
"city": "BARBERTON",
"state": "OH",
"postal_code": "44203",
"telephone_number": "330-848-5383"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIOTT",
"first_name": "JACQUELINE",
"middle_name": "ANNA MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "OH",
"license": "2272503",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2272503",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Barberton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.