Individual provider Active NPI

Deborah Kacic, LMT

  • Doula
  • Medina, OH
National Provider Identifier
1164777280
Registry record updated Jul 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DoulaTaxonomy code 374J00000X
Practice address
750 E Washington St
Suite A6
Medina, OH 44256-2196
Phone
(330) 721-9357
NPI assigned
Jul 14, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Doula 374J00000X Primary

Addresses

Primary practice location

750 E Washington St
Suite A6
Medina, OH 44256-2196

Mailing address

5354 Lance Rd
Medina, OH 44256-7521
Phone (330) 635-7026

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

NPI Registry JSON

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

{
    "created_epoch": "1342224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342224000000",
    "number": "1164777280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5354 LANCE RD",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442567521",
            "telephone_number": "330-635-7026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E WASHINGTON ST",
            "address_2": "SUITE A6",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442562196",
            "telephone_number": "330-721-9357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KACIC",
        "first_name": "DEBORAH",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-14",
        "last_updated": "2012-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medina, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2012; 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.