Suzanne Marie Kubancik, M.S.CCC-A

Primary specialty

AudiologistTaxonomy code 231H00000X

License

A01028 Issued in OH

Practice address

109 Plaza Dr
Saint Clairsville, OH 43950-7713

Phone

(740) 695-1058

Fax

(740) 695-0889

NPI assigned

Apr 5, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in OH, WV2 enrollments

Enrollment records 2

Specialty

Qualified Audiologist

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Linda L DavisonGroup PAC ID 6204077035, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Linda L Davison

  dba Professional Hearing Healthcare Services

  • Audiologist
  • Saint Clairsville, OH
  • NPI 1851738389
  Medicare reassignment Care Compare group NPD
• Linda L Davison, MA CCCA

  • Audiologist
  • Saint Clairsville, OH
  • NPI 1134215874

  WV

  Medicare reassignment
• Terry L Williams O D Inc

  dba Glen Dale Vision Center

  • Optometrist
  • Glen Dale, WV
  • NPI 1053393645
  NPD (past)

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

{
    "created_epoch": "1365120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1275876419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 SPRING PARK AVE",
            "city": "SAINT CLAIRSVILLE",
            "state": "OH",
            "postal_code": "439508538",
            "telephone_number": "304-695-1058",
            "fax_number": "740-695-0889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 PLAZA DR",
            "city": "SAINT CLAIRSVILLE",
            "state": "OH",
            "postal_code": "439507713",
            "telephone_number": "740-695-1058",
            "fax_number": "740-695-0889"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "317 Whitten Ln",
            "address_purpose": "LOCATION",
            "city": "New Martinsville",
            "state": "WV",
            "postal_code": "261552145",
            "country_code": "US",
            "telephone_number": "740-695-1058",
            "fax_number": "740-695-0889",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "51687 National Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Clairsville",
            "state": "OH",
            "postal_code": "439509304",
            "country_code": "US",
            "telephone_number": "740-695-1058",
            "fax_number": "740-695-0889",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12 Wheeling Ave",
            "address_purpose": "LOCATION",
            "city": "Glen Dale",
            "state": "WV",
            "postal_code": "260381529",
            "country_code": "US",
            "telephone_number": "740-695-1058",
            "fax_number": "740-695-0889",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Barnesville",
            "state": "OH",
            "postal_code": "437131098",
            "country_code": "US",
            "telephone_number": "740-695-1058",
            "fax_number": "740-695-0889",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUBANCIK",
        "first_name": "SUZANNE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "M.S.CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-05",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "PA",
            "license": "AT005978",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "WV",
            "license": "A0120",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OH",
            "license": "A01028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Jo Koshenko, M.S. CCC/SLP
• Jennifer Lynn Kotsanis, NP
• Carol Kovachic
• Amy Kovalski
• Benjamin Michael Kravetz, LPTA
• Myranda Marie Kuhn
• Angel Kulpa, LPN
• Lindsey Jo Kulpa
• Esi Kumi-Sakyi
• Connie Kunze

• Audiologist in Saint Clairsville, OH
• Providers in Saint Clairsville, OH by specialty
• Audiologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.