Mary Ann Novak

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

057530 Issued in OH

Practice address

15655 State Route 170 Ste a
East Liverpool, OH 43920-9672

Phone

(330) 386-4303

NPI assigned

Jan 10, 2023

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Department of Veteran'S Affairs

  • Public Health or Welfare Agency
  • Calcutta, OH
  • NPI 1073761490
  NPD (past)

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

{
    "created_epoch": "1673308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1083328405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15655 STATE ROUTE 170 STE A",
            "city": "EAST LIVERPOOL",
            "state": "OH",
            "postal_code": "439209672",
            "telephone_number": "330-386-4303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15655 STATE ROUTE 170 STE A",
            "city": "EAST LIVERPOOL",
            "state": "OH",
            "postal_code": "439209672",
            "telephone_number": "330-386-4303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVAK",
        "first_name": "MARY ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-10",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "057530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "securerecords.sanford.html",
            "affiliation": "N",
            "address_1": "15655 State Route 170 Ste A",
            "city": "East Liverpool",
            "state": "OH",
            "country_code": "US",
            "postal_code": "439209672",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Thu Nguyen, DDS
• Gretchen Leigh Nickell, DO
• Pukhraj Nijhar, M.D.
• Teja Srinivas Niruogi, MD
• North Star Critical Care LLC
• James Novobilsky, DO
• Anastasia Hope Novotny
• Rohan Kumar Nuthakki
• Jessica A Oates, LPCC
• Oh Eye Associates Inc

• Licensed Practical Nurse in East Liverpool, OH
• Providers in East Liverpool, OH by specialty
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.