Individual provider Active NPI

Lori J Davello, MD

  • Pediatrics Physician
  • Fairlawn, OH
National Provider Identifier
1194717199
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35-05-7622 Issued in OH
Practice address
3800 Embassy Pkwy Ste 260
Fairlawn, OH 44333-8398
Phone
(330) 664-8120
Fax
(330) 664-8121
NPI assigned
Aug 17, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35-05-7622 OH Primary

Addresses

Primary practice location

3800 Embassy Pkwy Ste 260
Fairlawn, OH 44333-8398

Mailing address

3800 Embassy Pkwy Ste 260
Fairlawn, OH 44333-8398
Phone (330) 664-8120

Other practice location 1

5603 Darrow Rd Ste 200
Hudson, OH 44236-5015
Phone (330) 486-9780

Other identifiers 1

IdentifierTypeStateIssuer
0733415MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address loridavello@uhps.allscriptsdirect.net

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
Credentials
Doctor of Medicine

Interoperability endpoints

  • Direct secure messaging: ldavello36956@ehrdirect.uhhospitals.org

NPI Registry JSON

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

{
    "created_epoch": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1194717199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 EMBASSY PKWY STE 260",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443338398",
            "telephone_number": "330-664-8120",
            "fax_number": "330-664-8121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 EMBASSY PKWY STE 260",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443338398",
            "telephone_number": "330-664-8120",
            "fax_number": "330-664-8121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5603 Darrow Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Hudson",
            "state": "OH",
            "postal_code": "442365015",
            "country_code": "US",
            "telephone_number": "330-486-9780",
            "fax_number": "330-486-3411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVELLO",
        "first_name": "LORI",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-17",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35-05-7622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0733415",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "loridavello@uhps.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "3800 Embassy Pkwy Ste 260",
            "city": "Fairlawn",
            "state": "OH",
            "country_code": "US",
            "postal_code": "443338398",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fairlawn, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; 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.