Individual provider Active NPI

Paula Mary Farner, MD

  • Pediatrics Physician
  • Avon, OH
National Provider Identifier
1053351718
Registry record updated Jun 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35047906 Issued in OH
Practice address
36595 Detroit Rd
Avon, OH 44011-1509
Phone
(440) 934-4070
Fax
(440) 934-4884
NPI assigned
Jun 8, 2006
Last updated
Jun 1, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35047906 OH Primary

Addresses

Primary practice location

36595 Detroit Rd
Avon, OH 44011-1509

Mailing address

36595 Detroit Rd
Avon, OH 44011-1509
Phone (440) 934-4070

Other identifiers 2

IdentifierTypeStateIssuer
0629038MedicaidOH
942460636329OtherOHCARESOURCE

Other names 1

  • Paula M Farner Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130425000731 OH Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 5395981914

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35047906OHMDPediatrics Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433116800000",
    "number": "1053351718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36595 DETROIT RD",
            "city": "AVON",
            "state": "OH",
            "postal_code": "440111509",
            "telephone_number": "440-934-4070",
            "fax_number": "440-934-4884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36595 DETROIT RD",
            "city": "AVON",
            "state": "OH",
            "postal_code": "440111509",
            "telephone_number": "440-934-4070",
            "fax_number": "440-934-4884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARNER",
        "first_name": "PAULA",
        "middle_name": "MARY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2015-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35047906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0629038",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE",
            "identifier": "942460636329",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAULA",
            "last_name": "FARNER",
            "middle_name": "M",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Avon, OH

Sources for this page

Verify at the official NPI Registry.