SELF (NPI# 1659789915) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659789915 |
| Entity Type | Organization |
| Organization Name | SELF |
| Practice Address |
33803 Electric Blvd E4 Avonlake OH 44012 |
| Practice Telephone | 4409334156 |
| Mailing Telephone | 4409334156 |
| Enumeration Date | 2014-07-30 |
| Last Update Date | 2014-08-13 |
| Authorized Official Name | MS. SANDRA LYNN PESTA (LPN) |
| Authorized Official Telephone | 4409334156 |
| Authorized Official Credential | LPN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | PN080509 | OH | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508319666 | Self | Community/Behavioral Health | 117 Valley St, Glenwood, IA 51534-1024 | 2016-07-25 |
| 1568814390 | Self | Clinic/Center | 19 Merrick Ave Apt 1, Springfield, MA 01109-4324 | 2016-07-05 |
| 1740655471 | Self | Clinic/Center | 7627 Key West Dr, Parma, OH 44134-6624 | 2015-12-07 |
| 1215333901 | Self | Physical Therapist | 410 Jason Dr, Richmond, KY 40475-2291 | 2014-11-07 |
| 1811334758 | Self | Skilled Nursing Facility | 4 Spruce Rd, Amityville, NY 11701-1019 | 2013-06-02 |
| 1699019786 | Self | Health Maintenance Organization | 10136 Amigo Ave, Northridge, CA 91324-1301 | 2012-11-15 |
| 1861781759 | Self | Licensed Practical Nurse | 29 Heberton Rd, Rochester, NY 14622-2405 | 2011-03-31 |
| 1649599135 | Self | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1965 Lafayette Ave, Apt. 1g, Bronx, NY 10473-2502 | 2010-05-23 |
| 1912372822 | Self | Community/Behavioral Health | 5010 E Shea Blvd Ste D202, Scottsdale, AZ 85254-4570 | 2015-12-02 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SELF | 214 Ceret Ct Sw, Vienna, VA 22180-6210 |
| Colorado Business Entities | Self !mprovment, LLC | 3416 White Oak Ln, Highlands Ranch, CO 80129 |
| System for Award Management (SAM) Entities | SELF & SELF GENERAL CONTRACTORS | 494 Grv St N, Dahlonega, GA 30533-0432 |
| System for Award Management (SAM) Entities | SELF --- SUPPORT FOR EARLY LEARNING & FAMILIES | 12214 Se Mill Plain Blvd Ste 203, Vancouver, WA 98684-6019 |
| Washington State Corporations | SELF ACCESS STORAGE, LLC | 102 Myers St, Rainier, WA 98576 |
| Colorado Business Entities | Self Aerial Spraying, LLC | 762 W. 5th Ave., Springfield, CO 81073 |
| Oregon Corporations, Companies and Business Names | SELF ALIGNMENT YOGA LLC | 9554 N Buchanan Ave, Portland, OR 97203 |
| Colorado Business Entities | Self and Associates, LLC | 0705 Nogal Rd, Unit A9, Eagle, CO 81631 |
| Oregon Corporations, Companies and Business Names | SELF AND SOUL CENTER | 9820 Wagner Crk Rd, Talent, OR 97540 |
| Colorado Business Entities | Self Asset Management LLC | 9770 W Frost Pl, Littleton, CO 80128 |
| Street Address |
33803 ELECTRIC BLVD E4 |
| City | AVONLAKE |
| State | OH |
| Zip Code | 44012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649743352 | Wyatt Demarco Massage Therapy & Wellness Center | Massage Therapist | 690 Avon Belden Rd, 2c, Avon Lake, OH 44012 | 2019-01-04 |
| 1427489566 | Thomas Gerosky, D.m.d. Inc | Dentist | 215 Miller Road, Avon Lake, OH 44012 | 2013-11-27 |
| 1558619676 | Lindsay Stein | Counselor | 156a Lear Rd, Avon Lake, OH 44012 | 2012-08-21 |
| 1023388063 | Jennifer Lynn Dorman | Dietitian, Registered | 167 Belmar Boulevard, Avon Lake, OH 44012 | 2012-01-09 |
| 1033495338 | Jessica Rae Wyatt | Massage Therapist | 690 Avon Belden Rd Ste 2c, Avon Lake, OH 44012 | 2011-10-31 |
| 1841599248 | Robin M Hale | Counselor | 32831 Redwood Blvd, Avon Lake, OH 44012 | 2011-03-24 |
| 1265551766 | Robert Day Monroe | Podiatrist | 32118 Augusta Dr, Avon Lake, OH 44012 | 2007-03-28 |
| 1194822908 | John Secrest Pyke IIi | Dentist | 33399 Walker Rd, Suite D, Avon Lake, OH 44012 | 2006-09-20 |
| 1295842284 | Westshore Primary Care Assoc Inc | Internal Medicine | 32730 Walker Road, Building H, Avon Lake, OH 44012 | 2006-08-24 |
| 1316974751 | Sandra M Drotos | Occupational Therapist | 533 Bayhill Drive, Suite 108, Avon Lake, OH 44012 | 2006-06-28 |
| Find all providers in zip 44012 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952902025 | Cassandra Tubbs | Home Health | 1462 S 13th St, Coshocton, OH 43812-2661 | 2020-11-05 |
| 1376144394 | Tammy C Sanders | Home Health | 14604 Reddington Ave, Maple Heights, OH 44137-3218 | 2020-11-05 |
| 1144821273 | Kerry N Miller II | Home Health | 1020 Huffman Ct, Cincinnati, OH 45231 | 2020-11-04 |
| 1154922334 | Lisa Marie Hard | Home Health | 2000 Us Highway 23 N Lot 86, Delaware, OH 43015-8647 | 2020-11-04 |
| 1902407117 | Serene Home Health Services | Home Health | 4812 Frederick Pike Ste 105, Dayton, OH 45414-3835 | 2020-11-04 |
| 1396346706 | Shardonia Bianca Paguada | Home Health | 554 Elda St, Columbus, OH 43203-1105 | 2020-11-03 |
| 1750982062 | Leah Denise Nicole Dutch | Home Health | 547 Carpenter St, Akron, OH 44310-2965 | 2020-11-03 |
| 1538760970 | Shirley Odessa Hairston | Home Health | 1802 Fallbrook Lane, Cincinnati, OH 45240 | 2020-11-03 |
| 1285235697 | Tennie E Millhouse | Home Health | 12808 Summerland Ave, Cleveland, OH 44111-5167 | 2020-11-03 |
| 1558962811 | Rachel Brett Higgins | Home Health | 900 Harris Station Rd, Bainbridge, OH 45612-9734 | 2020-11-03 |
| 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.