Individual provider Active NPI

Karen Lynn Ponomarenko

  • Pediatric Registered Nurse
  • Parma, OH
National Provider Identifier
1104686468
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Registered NurseTaxonomy code 163WP0200X
License
RN256825 Issued in OH
Practice address
5918 Broadview Rd
Parma, OH 44134-3105
Phone
(216) 314-1076
NPI assigned
Mar 21, 2024
Last updated
Mar 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WP0200X RN256825 OH Primary

Addresses

Primary practice location

5918 Broadview Rd
Parma, OH 44134-3105

Mailing address

5918 Broadview Rd
Parma, OH 44134-3105
Phone (216) 314-1076

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

LicenseStateTypeSpecialty
RN256825OHMDPediatric Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1710979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1104686468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5918 BROADVIEW RD",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "441343105",
            "telephone_number": "216-314-1076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5918 BROADVIEW RD",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "441343105",
            "telephone_number": "216-314-1076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONOMARENKO",
        "first_name": "KAREN",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-21",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Pediatrics",
            "state": "OH",
            "license": "RN256825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parma, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; 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.