Individual provider Active NPI

Katelynn Beyonce Bracey

  • Nursing Home Administrator
  • Cleveland, OH
National Provider Identifier
1972476372
Registry record updated Oct 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Home AdministratorTaxonomy code 376G00000X
Practice address
11900 Fairhill Rd
Cleveland, OH 44120-1062
Phone
(216) 983-8030
NPI assigned
Sep 24, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Home Administrator 376G00000X OH Primary

Addresses

Primary practice location

11900 Fairhill Rd
Cleveland, OH 44120-1062

Mailing address

11900 Fairhill Rd
Cleveland, OH 44120-1062
Phone (216) 983-8030

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

NPI Registry JSON

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

{
    "created_epoch": "1758672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1972476372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11900 FAIRHILL RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441201062",
            "telephone_number": "216-983-8030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11900 FAIRHILL RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441201062",
            "telephone_number": "216-983-8030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACEY",
        "first_name": "KATELYNN",
        "middle_name": "BEYONCE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-24",
        "last_updated": "2025-10-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376G00000X",
            "taxonomy_group": "",
            "desc": "Nursing Home Administrator",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2025; 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.