Vivian Irene Balzer, RN

Primary specialty

Child & Adolescent Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0807X

License

239488 Issued in OH

Practice address

22001 Fairmount Blvd
Shaker Heights, OH 44118-4819

Phone

(216) 320-8420

NPI assigned

May 21, 2019

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1558396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1104483601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22001 FAIRMOUNT BLVD",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441184819",
            "telephone_number": "216-320-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22001 FAIRMOUNT BLVD",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441184819",
            "telephone_number": "216-320-8420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALZER",
        "first_name": "VIVIAN",
        "middle_name": "IRENE",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-21",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "OH",
            "license": "239488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Child & Adolescent Psychiatric/Mental Health Registered Nurse in Shaker Heights, OH
• Providers in Shaker Heights, OH by specialty
• Child & Adolescent Psychiatric/Mental Health Registered Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.