Healthcare Provider Details

I. General information

NPI: 1619750056
Provider Name (Legal Business Name): JAMES CODY CARTER JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2023
Last Update Date: 03/22/2025
Certification Date: 03/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 E BROAD STREET UNIT 332 20 E BROAD STREET UNIT 332
COLUMBUS OH
43215-5880
US

IV. Provider business mailing address

20 E BROAD STREET UNIT 332 20 E BROAD STREET UNIT 332
COLUMBUS OH
43215-5880
US

V. Phone/Fax

Practice location:
  • Phone: 614-762-0232
  • Fax:
Mailing address:
  • Phone: 614-762-0232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: