Individual provider Active NPI

Carolyn Zaitzew Merry, AUD

  • Audiologist
  • Boardman, OH
National Provider Identifier
1093385510
Registry record updated Jun 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
A.02328 Issued in OH
Practice address
126 York Ave
Boardman, OH 44512-5615
Phone
(330) 726-3339
NPI assigned
Jun 28, 2021
Last updated
Jun 28, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X A.02328 OH Primary

Addresses

Primary practice location

126 York Ave
Boardman, OH 44512-5615

Mailing address

2905 Autumnwood TRL
Poland, OH 44514-2860
Phone (330) 330-0877

Other practice location 1

3622 Belmont Ave Ste 19
Youngstown, OH 44505-1444
Phone (330) 759-3593

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210817001818 OH Practitioner - Qualified Audiologist 1254736051 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Audiology Associates of Northeast Ohio IncGroup PAC ID 1759486004, 6 clinicians

Practice addresses (Care Compare)

126 York Ave
Boardman, OH 44512-5615
Phone (330) 726-3339

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A.02328OHMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Audiology Associates of Salem, Inc Audiologist CurrentSince Jun 21, 2021 Accepting new patients
Audiology Associates of Northeast Ohio Inc. Audiologist CurrentSince Jun 21, 2021 Accepting new patients

Locations

980 W State St
Salem, OH 44460
Phone (330) 337-3332

8309 High St NE
Warren, OH 44484
Phone (330) 394-3300

126 York Ave
Youngstown, OH 44512
Phone (330) 726-3339

1400 S Raccoon Rd
Youngstown, OH 44515
Phone (330) 270-4327

3622 Belmont Ave
Ste 19
Youngstown, OH 44505
Phone (330) 759-3593

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1624838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1093385510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2905 AUTUMNWOOD TRL",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445142860",
            "telephone_number": "330-330-0877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 YORK AVE",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445125615",
            "telephone_number": "330-726-3339"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3622 Belmont Ave Ste 19",
            "address_purpose": "LOCATION",
            "city": "Youngstown",
            "state": "OH",
            "postal_code": "445051444",
            "country_code": "US",
            "telephone_number": "330-759-3593",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MERRY",
        "first_name": "CAROLYN",
        "middle_name": "ZAITZEW",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-28",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OH",
            "license": "A.02328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boardman, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.