Provider Demographics
NPI:1619750056
Name:CARTER, JAMES CODY JR
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:CODY
Last Name:CARTER
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2722 TENNYSON BLVD APT D
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-5039
Mailing Address - Country:US
Mailing Address - Phone:614-477-6899
Mailing Address - Fax:
Practice Address - Street 1:1534 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45237-5910
Practice Address - Country:US
Practice Address - Phone:614-477-6899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-18
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemaker