MRS. RANDI GANOE GILLETTE (NPI# 1700930997) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700930997 |
| Entity Type | Individual |
| Full Name | MRS. RANDI GANOE GILLETTE |
| Practice Address |
40295 Burlingham Road Shade OH 45776 |
| Practice Telephone | 7406960068 |
| Mailing Telephone | 7406960068 |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2007-07-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3747P1801X |
Technician Specialization: Personal Care Attendant |
Nursing Service Related Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2353117 | 05 |
| Street Address |
40295 BURLINGHAM ROAD |
| City | SHADE |
| State | OH |
| Zip Code | 45776 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427102623 | Jesse Arra Gillette | Technician | 40295 Burlingham Rd, Shade, OH 45776 | 2007-01-23 |
| 1386245025 | Virginia A Patton | Technician | 40560 Burlingham Rd Bsmt, Shade, OH 45776-9556 | 2020-11-07 |
| 1619389400 | Erin Elizabeth Thomas | Speech-Language Pathologist | 1101 Carter Rd, Shade, OH 45776-9670 | 2014-05-28 |
| Taxonomy Code | 3747P1801X |
| Grouping | Nursing Service Related Providers |
| Classification | Technician |
| Specialization | Personal Care Attendant |
| An individual who provides assistance with eating, bathing, dressing, personal hygiene, activities of daily living as specified in the plan of care. Services which are incidental to the care furnished, or essential to the health and welfare of the individual may also be provided. Personal care providers must meet state defined training and certification standards |
| Notes: [7/1/2003: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386245025 | Virginia A Patton | Technician | 40560 Burlingham Rd Bsmt, Shade, OH 45776-9556 | 2020-11-07 |
| 1427102623 | Jesse Arra Gillette | Technician | 40295 Burlingham Rd, Shade, OH 45776 | 2007-01-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013518703 | Matthew Gaylor | Technician | 6 Coral Cir, Belpre, OH 45714-1553 | 2020-11-08 |
| 1245831916 | Nicole Bosworth | Technician | 5718 Rousseau Dr, Huber Heights, OH 45424-4329 | 2020-11-08 |
| 1104427863 | Amanda Jo Simulcik | Technician | 3933 Courtyard Dr, Lorain, OH 44053-4431 | 2020-11-07 |
| 1487255261 | Lori Danielle Hann | Technician | 361 York Ave, Delaware, OH 43015-1578 | 2020-11-06 |
| 1346841137 | Jamison Ward Howell | Technician | 300 W Cross St, Morristown, OH 43759-0134 | 2020-11-06 |
| 1154922078 | Shannon Sebring | Technician | 16837 Highland Ave, Caldwell, OH 43724-9655 | 2020-11-06 |
| 1093316002 | William Patrick Gay | Technician | 134 Smith St, Portsmouth, OH 45662-8766 | 2020-11-05 |
| 1780285684 | Brenda Mcallister | Technician | 10089 High St, Rarden, OH 45671-9047 | 2020-11-05 |
| 1780285742 | Ivan William Miller Jr. | Technician | 241 Silvercrest Dr, Lexington, OH 44904-9364 | 2020-11-05 |
| 1003417007 | Katie M Yoder | Technician | 6659 County Road 77, Millersburg, OH 44654-7901 | 2020-11-05 |
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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.