NICOLE D ENDRES (NPI# 1386242782) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386242782 |
| Entity Type | Individual |
| Full Name | NICOLE D ENDRES |
| Practice Address |
109 N Main St Ste 209 Mansfield OH 44902-7669 |
| Practice Telephone | 4192958324 |
| Practice Fax Number | 5675602032 |
| Mailing Telephone | 4192958324 |
| Mailing Fax Number | 5675602032 |
| Enumeration Date | 2020-10-16 |
| Last Update Date | 2020-10-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 172A00000X | Driver | Other Service Providers | ||
| N | 347C00000X | Private Vehicle | Transportation Services | ||
| N | 3747P1801X |
Technician Specialization: Personal Care Attendant |
Nursing Service Related Providers | ||
| N | 374U00000X | Home Health Aide | Nursing Service Related Providers | ||
| N | 376J00000X | Homemaker | Nursing Service Related Providers | ||
| N | 253Z00000X | In Home Supportive Care | Agencies | ||
| Y | 251X00000X | Supports Brokerage | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0365521 | 05 | |
| OH | SUPPLIER | 0000263838 | 01 |
| OH | DODD PROVIDERCONTRACT | 1701260 | 01 |
| Street Address |
109 N MAIN ST STE 209 |
| City | MANSFIELD |
| State | OH |
| Zip Code | 44902-7669 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376069757 | Deborah L Niederhuber | Registered Nurse | 40 W 4th St., Mansfield, OH 44902 | 2017-08-17 |
| 1174978183 | Rebecca A Wagers | Community Health Worker | 28 Park Avenue West, Suite 300, Mansfield, OH 44902 | 2016-04-27 |
| 1053644336 | The Sun Home Health Care At Mansfield, Inc | Home Health | 166 Park Ave W., Suite 205, Mansfield, OH 44902 | 2009-09-17 |
| 1821248899 | Yanke Bionics Inc | Prosthetic/Orthotic Supplier | 380 N. Main St., Suite L101, Mansfield, OH 44902 | 2008-09-25 |
| 1518134824 | Walter E Glenn Dds Inc | Dentist | 13 Park Ave West Suite 517, Walter E Glenn Dds Inc, Mansfield, OH 44902 | 2008-05-15 |
| 1174708853 | Medical Service Companies | Durable Medical Equipment & Medical Supplies | 92 N. Diamond St., Mansfield, OH 44902 | 2007-12-31 |
| 1225195449 | Rod L Staker | Dentist | 61 North Mulberry Street, Mansfield, OH 44902 | 2007-01-03 |
| 1841398328 | Velma F Anderson | Speech-Language Pathologist | 255 Hedges Street, Suite A, Mansfield, OH 44902 | 2006-09-20 |
| 1093746679 | Walter Edward Glenn | Dentist | 13 Park Avenue West, Suite 517, Mansfield, OH 44902 | 2006-07-05 |
| 1023056702 | First Choice Home Health of Ohio Inc | Home Health | 1227 Park Ave West, Mansfield, OH 44902 | 2006-06-03 |
| Find all providers in zip 44902 | ||||
| Taxonomy Code | 251X00000X |
| Grouping | Agencies |
| Classification | Supports Brokerage |
| A provider of service/function that assists participating individuals to make informed decisions about what will work best for them is consistent with their needs and reflects their individual circumstances. Serving as the agent of the individual, the service is available to assist in identifying immediate and long-term needs, developing options to meet those needs and accessing identified supports and services and may include assistance with recruiting, screening, hiring, and training in-home support providers. A family or person-centered planning approach is used. Supports Brokerage offers practical skills training to enable families and individuals to remain independent. Examples of skills training include providing information on recruiting and hiring personal care workers, managing personal care workers and providing information on effective communication and problem solving. The service/function provides sufficient information to assure that individuals understand the responsibilities involved with self-direction and assist in the development of an effective back-up and emergency plan. Plans may elect to fulfill the requirement of this service/function using a self-directed case manager or creating a distinct service. The Supports Brokerage documents the need for assistive services, planning for and documenting the use of excess funds and locating and maintaining services. |
| Notes: Source: CMS Independence Plus Waiver template. [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205436573 | Reaach, LLC | Supports Brokerage | 202b W High St, Minerva, OH 44657-1625 | 2020-10-27 |
| 1760080725 | Hunter Brooke Richards | Supports Brokerage | 1669 Maumee Dr, Xenia, OH 45385-4216 | 2020-10-13 |
| 1942816608 | Sunshine In Home Care and Assistance Ltd. | Supports Brokerage | 5583 Rosebrook Way, Mason, OH 45040-5777 | 2020-09-18 |
| 1962017202 | Highco Incorporated | Supports Brokerage | 5215 Us Highway 50, Hillsboro, OH 45133-9166 | 2020-09-14 |
| 1659812501 | Lld Connect, LLC | Supports Brokerage | 4540 Shady Blossom Ln, Columbus, OH 43230-7546 | 2017-03-12 |
| 1770024614 | Insite Foundation Inc. | Supports Brokerage | 8075 Reading Rd Ste 306, Cincinnati, OH 45237-1416 | 2017-03-11 |
| 1164970315 | Linda Scarcella | Supports Brokerage | 2202 Northgate Dr, Hinckley, OH 44233-8105 | 2016-09-16 |
| 1043630015 | Formfire, LLC | Supports Brokerage | 1360 E 9th St, Suite 850, Cleveland, OH 44114-1737 | 2014-04-17 |
| 1336562495 | Walter E Matthews & Assoc Inc | Supports Brokerage | 1327 Fifth Street, Sandusky, OH 44870 | 2014-01-27 |
| 1144651738 | The Ohio Pia Service Corporation, Inc. | Supports Brokerage | 600 Cross Pointe Rd, Gahanna, OH 43230-6696 | 2013-12-06 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.