SELF-EMPLOYED (NPI# 1689077125) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689077125 |
| Entity Type | Organization |
| Organization Name | SELF-EMPLOYED |
| Practice Address |
95b Barley Dr Painesville OH 44077-5349 |
| Practice Telephone | 4402519701 |
| Mailing Telephone | 4402519701 |
| Enumeration Date | 2014-09-29 |
| Last Update Date | 2014-09-29 |
| Authorized Official Name | DELMESHA JACKSON (STNA) |
| Authorized Official Telephone | 4402519701 |
| Authorized Official Credential | HOMEHEALTH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 293D00000X | Physiological Laboratory | 47 | OH | Laboratories |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SELF-EMPLOYED | 1209 Seymour St, Grand Ledge, MI 48837-2130 |
| Street Address |
95B BARLEY DR |
| City | PAINESVILLE |
| State | OH |
| Zip Code | 44077-5349 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528461266 | Delmesha Jackson | Nurse's Aide | 95b Barley Dr, Painesville, OH 44077-5349 | 2014-10-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821695594 | Signature Health Inc. Pharmacy | Pharmacy | 54 South Saint Claire, Painesville, OH 44077 | 2020-10-06 |
| 1164053385 | Elaine Marie Nelson | Technician, Other | Cosmetic Laser Inc, 8353 Mentor Ave. Unit 7, Mentor, OH 44077 | 2020-01-27 |
| 1760039309 | Laura Bradford | Occupational Therapy Assistant | 12428 Concord-hambden Road, Concord, OH 44077 | 2019-08-19 |
| 1508418260 | Collin Dees | Physician Assistant | Tripoint Medical Center, 7590 Auburn Road, Painesville, OH 44077 | 2019-07-12 |
| 1093208662 | Lindsey Elaine Varckette | Physical Therapy Assistant | 60 Wood Street, Painesville, OH 44077 | 2018-06-08 |
| 1083116578 | Brian Mills | Hearing Instrument Specialist | 1920 Mentor Ave, Painesville, OH 44077 | 2018-03-01 |
| 1033610324 | Julia Nicole Chase | Pharmacist | 180 W State Street, Painesville, OH 44077 | 2018-02-22 |
| 1104343631 | Donna Sheahan | Nurse Practitioner | 236 Ardmore Blvd, Painesville, OH 44077 | 2017-08-25 |
| 1417474198 | Jacqueline Owens | Registered Nurse | 7757 Auburn Rd, Ste 6 &7, Concord Twp., OH 44077 | 2017-08-24 |
| 1689197303 | Michelle Claire Pierce | Registered Nurse | 311 W. Walnut Ave., Painesville, OH 44077 | 2017-07-25 |
| Find all providers in zip 44077 | ||||
| Taxonomy Code | 293D00000X |
| Grouping | Laboratories |
| Classification | Physiological Laboratory |
| A laboratory that operates independently of a hospital and physician’s office to furnish physiological diagnostic services (e.g. EEG’s , EKG’s, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services. |
| Notes: Source: Paraphrased from the Medicare Carrier Manual, Section 2070.5. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912356726 | Ordinary24, LLC | Physiological Laboratory | 4301 Darrow Rd, Suite 4400a, Stow, OH 44224-2694 | 2016-06-13 |
| 1508239161 | Mccullough Hyde Memorial Hospital Inc | Physiological Laboratory | 79 W Central Ave Ste 2, Camden, OH 45311-1007 | 2015-11-04 |
| 1689000580 | American Mobile X-ray, LLC | Physiological Laboratory | 6802 Menz Ln, Cincinnati, OH 45233-4311 | 2013-09-24 |
| 1669731865 | Zin Medical Inc | Physiological Laboratory | 10000 Cedar Ave, Suite 2-131 Mail Stop #17, Cleveland, OH 44106-2103 | 2012-05-08 |
| 1013140524 | The Cos Companies | Physiological Laboratory | 820 S North St, Washington Court House, OH 43160-2262 | 2009-08-31 |
| 1285808071 | Specialized Pulse Oximetry Testing Service, LLC | Physiological Laboratory | 1436 Yankee Park Pl # K, Dayton, OH 45458-1899 | 2008-04-14 |
| 1831303551 | Trendy Oximetry Ltd | Physiological Laboratory | 6048l W Central Ave, Toledo, OH 43615-1872 | 2007-05-10 |
| 1063539062 | Neumed | Physiological Laboratory | 9906 Norwalk Rd, Litchfield, OH 44253-9502 | 2007-03-23 |
| 1316075179 | King's Medical Imaging At Watermark, LLC | Physiological Laboratory | 5339 Hendron Rd, Groveport, OH 43125-1055 | 2007-03-01 |
| 1013004936 | Regional Mri of Toledo, Inc. | Physiological Laboratory | 6060 Renaissance Pl, Toledo, OH 43623-4724 | 2006-10-10 |
| Find all providers with the same taxonomy | ||||
| City | PAINESVILLE |
| Zip Code | 44077 |
Please comment or provide details below to improve the information on SELF-EMPLOYED.
| 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.