Active NPI
Charles Ross, PHD
- Psychologist
- Lorain, OH
National Provider Identifier
1255715918
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 2893
- Practice address
- 2115 W Park Dr
Lorain, OH 44053-1138 - Phone
- (440) 989-4922
- Fax
- (440) 282-4779
- NPI assigned
- Jul 13, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 2893 | OH | Primary |
Addresses
Primary practice location
2115 W Park Dr
Lorain, OH 44053-1138
Mailing address
2115 W Park Dr
Lorain, OH 44053-1138
Phone (440) 989-4922
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2893 | OH | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436745600000",
"number": "1255715918",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2115 W PARK DR",
"city": "LORAIN",
"state": "OH",
"postal_code": "440531138",
"telephone_number": "440-989-4922",
"fax_number": "440-282-4779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2115 W PARK DR",
"city": "LORAIN",
"state": "OH",
"postal_code": "440531138",
"telephone_number": "440-989-4922",
"fax_number": "440-282-4779"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSS",
"first_name": "CHARLES",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-07-13",
"last_updated": "2015-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OH",
"license": "2893",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lorain, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.