Individual provider Active NPI

Michael McDonald

  • In Home Supportive Care Agency
  • Middletown, OH
National Provider Identifier
1982295580
Registry record updated Jan 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Practice address
5864 Hayden Dr
Middletown, OH 45042-3109
Phone
(937) 550-6186
NPI assigned
Jan 27, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X OH Primary

Addresses

Primary practice location

5864 Hayden Dr
Middletown, OH 45042-3109

Mailing address

5864 Hayden Dr
Middletown, OH 45042-3109
Phone (937) 550-6186

Other identifiers 1

IdentifierTypeStateIssuer
0427035MedicaidOH

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": "1611705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611705600000",
    "number": "1982295580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5864 HAYDEN DR",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450423109",
            "telephone_number": "937-550-6186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5864 HAYDEN DR",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450423109",
            "telephone_number": "937-550-6186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-27",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0427035",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2021; 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.