Active NPI
Rebecca Paris
- Community/Behavioral Health Agency
- Lorain, OH
National Provider Identifier
1063953743
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- License
- CDCA.161073-PRE
- Practice address
- 2115 W Park Dr
Lorain, OH 44053-1138 - Phone
- (440) 989-4987
- Fax
- (440) 246-0189
- NPI assigned
- Mar 15, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | CDCA.161073-PRE | OH | Primary |
Addresses
Primary practice location
2115 W Park Dr
Lorain, OH 44053-1138
Mailing address
2115 W Park Dr
Lorain, OH 44053-1138
Phone (440) 989-4987
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CDCA.161073-PRE | Other | OH | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CDCA.161073-PRE | OH | MD | Community/Behavioral Health Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1489536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489536000000",
"number": "1063953743",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2115 W PARK DR",
"city": "LORAIN",
"state": "OH",
"postal_code": "440531138",
"telephone_number": "440-989-4987",
"fax_number": "440-246-0189"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2115 W PARK DR",
"city": "LORAIN",
"state": "OH",
"postal_code": "440531138",
"telephone_number": "440-989-4987",
"fax_number": "440-246-0189"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARIS",
"first_name": "REBECCA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-03-15",
"last_updated": "2017-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "OH",
"license": "CDCA.161073-PRE",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "CDCA.161073-PRE",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lorain, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.