Individual provider Active NPI

Mary Poduch, L.P.N.

  • Licensed Practical Nurse
  • Strongsville, OH
National Provider Identifier
1154745990
Registry record updated Feb 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
20529490 Issued in OH
Practice address
19091 Waterford Pkwy
Strongsville, OH 44149-0936
Phone
(440) 268-5916
NPI assigned
Feb 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 20529490 OH Primary

Addresses

Primary practice location

19091 Waterford Pkwy
Strongsville, OH 44149-0936

Mailing address

19091 Waterford Pkwy
Strongsville, OH 44149-0936
Phone (440) 268-5916

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
20529490OHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1392336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392768000000",
    "number": "1154745990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19091 WATERFORD PKWY",
            "city": "STRONGSVILLE",
            "state": "OH",
            "postal_code": "441490936",
            "telephone_number": "440-268-5916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19091 WATERFORD PKWY",
            "city": "STRONGSVILLE",
            "state": "OH",
            "postal_code": "441490936",
            "telephone_number": "440-268-5916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PODUCH",
        "first_name": "MARY",
        "credential": "L.P.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-14",
        "last_updated": "2014-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "20529490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Strongsville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2014; 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.