Mary Theresa Halasz

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN.156420 Issued in OH

Practice address

14174 Ravenna Rd
Newbury, OH 44065-9511

Phone

(440) 739-0094

NPI assigned

May 6, 2020

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

State licenses

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

{
    "created_epoch": "1588723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1205457751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14174 RAVENNA RD",
            "city": "NEWBURY",
            "state": "OH",
            "postal_code": "440659511",
            "telephone_number": "440-739-0094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14174 RAVENNA RD",
            "city": "NEWBURY",
            "state": "OH",
            "postal_code": "440659511",
            "telephone_number": "440-739-0094"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14174 Ravenna Rd",
            "address_purpose": "LOCATION",
            "city": "Newbury",
            "state": "OH",
            "postal_code": "440659511",
            "country_code": "US",
            "telephone_number": "440-739-0094",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALASZ",
        "first_name": "MARY",
        "middle_name": "THERESA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-06",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN.156420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Licensed Practical Nurse in Newbury, OH
• Providers in Newbury, OH by specialty
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 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.