Audrey Havens, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

50.005775RX Issued in OH

Practice address

125 E Broad St
Elyria, OH 44035-6400

Phone

(440) 406-5500

NPI assigned

Jan 17, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Medical University of South Carolina College of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University Primary Care Practices IncGroup PAC ID 3072417534, 1,071 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Parma Community General Hospital Hospital, Parma, OH, CCN 360041
• Uh St John Medical Center Hospital, Westlake, OH, CCN 360123
• University Hospitals - Elyria Medical Center Hospital, Elyria, OH, CCN 360145

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ahoffmann25140@summahealth-direct.org
• Direct secure messaging: ahoffmann28455@ehrdirect.uhhospitals.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• University Primary Care Practices Inc

  • Gastroenterology Physician
  • Mentor, OH
  • NPI 1003935339
  Medicare reassignment Care Compare group
• University Primary Care Practices Inc

  • Internal Medicine Physician
  • Shaker Heights, OH
  • NPI 1720220098
  NPD
• University Primary Care Practices Inc

  • Orthopaedic Surgery Physician
  • Oberlin, OH
  • NPI 1982727087
  NPD
• University Primary Care Practices

  • Pediatrics Physician
  • Twinsburg, OH
  • NPI 1326166752
  NPD (past)
• Multicare Health System

  • Nurse Practitioner
  • Tacoma, WA
  • NPI 1407808413
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Emh Regional Medical Center

  • General Acute Care Hospital
  • Elyria, OH
  • NPI 1841299039
  Care Compare affiliation
• Parma Community General Hospital Association

  • General Acute Care Hospital
  • Parma, OH
  • NPI 1164481677
  Care Compare affiliation
• University Hospitals St. John Medical Center

  • General Acute Care Hospital
  • Westlake, OH
  • NPI 1841264868
  Care Compare affiliation

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

{
    "created_epoch": "1547683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1053885624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3417 W 148TH ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441112119",
            "telephone_number": "330-241-3202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 E BROAD ST",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440356400",
            "telephone_number": "440-406-5500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 Arch St Ste 301",
            "address_purpose": "LOCATION",
            "city": "Akron",
            "state": "OH",
            "postal_code": "443041429",
            "country_code": "US",
            "telephone_number": "330-253-1800",
            "fax_number": "330-253-1955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAVENS",
        "first_name": "AUDREY",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-17",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50.005775RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Lynn Hartley, PMHNP-BC
• Scott Michael Hartman, CNP
• Whitney Harvey-Bluher, MS
• Sydney Hatcher
• Richard Vincent Hausrod, MD
• Jillian N Hayes
• Michael Patrick Hayes, PT, ATC
• Miah Haynes, PA-C
• Renee Hayslett, PT
• Heart 2 Home by Chante' LLC

• Medical Physician Assistant in Elyria, OH
• Providers in Elyria, OH by specialty
• Medical Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.