Individual provider Active NPI

Lydia Abigaile Trabold, DC

  • Chiropractor
  • Westlake, OH
National Provider Identifier
1295488419
Registry record updated Jan 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
05147 Issued in OH
Practice address
29540 Center Ridge Rd
Westlake, OH 44145-5115
Phone
(440) 895-3500
Fax
(440) 895-3501
NPI assigned
Jan 28, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 05147 OH Primary

Addresses

Primary practice location

29540 Center Ridge Rd
Westlake, OH 44145-5115

Mailing address

29540 Center Ridge Rd
Westlake, OH 44145-5115
Phone (440) 895-3500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241115003957 OH Practitioner - Chiropractic 9931633633 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11100 Euclid Ave
Cleveland, OH 44106-1716
Phone (216) 383-0100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05147OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
University Primary Care Practices Inc Current Accepting new patients
Leonard Chiropractic Chiropractor CurrentSince Feb 1, 2022 Accepting new patients
University Primary Care Practices Inc CurrentSince Oct 1, 2024 Accepting new patients
University Primary Care Practices Inc CurrentSince Oct 1, 2024 Accepting new patients
University Primary Care Practices Past Accepting new patients
University Hospitals Medical Group Inc Past Accepting new patients

Locations

11100 Euclid Ave
Cleveland Heights, OH 44106

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

29540 Center Ridge Rd
Westlake, OH 44145
Phone (440) 895-3500

Interoperability endpoints

  • Direct secure messaging: ltrabold610301@ehrdirect.uhhospitals.org

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1643328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643328000000",
    "number": "1295488419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29540 CENTER RIDGE RD",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441455115",
            "telephone_number": "440-895-3500",
            "fax_number": "440-895-3501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29540 CENTER RIDGE RD",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441455115",
            "telephone_number": "440-895-3500",
            "fax_number": "440-895-3501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRABOLD",
        "first_name": "LYDIA",
        "middle_name": "ABIGAILE",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-28",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "05147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westlake, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2022; 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.