MEDICARE: MR. JAMES EDWARD TRAYLOR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	172A00000X	Driver	OH
2	347C00000X	Private Vehicle	OH
3	376J00000X	Homemaker	OH
4	3747P1801X	Personal Care Attendant	OH

General Provider Information

NPI Number	:	1174480578
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES EDWARD TRAYLOR

Provider Business Mailing Address
First Line	:	4971 E 141ST ST
Second Line	:
City	:	GARFIELD HEIGHTS
State	:	OH
Zip	:	44125-5033
Country	:	US
Telephone Number	:	440-228-1993
Fax Number	:

Provider Business Practice Location Address
First Line	:	4971 E 141ST ST
Second Line	:
City	:	GARFIELD HEIGHTS
State	:	OH
Zip	:	44125-5033
Country	:	US
Telephone Number	:	440-228-1993
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/07/2026
Last Update Date	:	01/18/2026

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