MEDICARE: JOHNITTA YATES

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)		OH
2	374U00000X	Home Health Aide	400699831207	OH
3	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1568236289
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHNITTA YATES

Provider Business Mailing Address
First Line	:	3916 ORCHARD RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44121-2412
Country	:	US
Telephone Number	:	216-374-7190
Fax Number	:

Provider Business Practice Location Address
First Line	:	3916 ORCHARD RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44121-2412
Country	:	US
Telephone Number	:	216-374-7190
Fax Number	:

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

Provider Enumeration Date	:	11/13/2023
Last Update Date	:	04/07/2025

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Directions to “ JOHNITTA YATES ” Practice Location

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