Organization Active NPI

H Douglas Hornbeck

  • Clinical Social Worker
  • Ashtabula, OH
National Provider Identifier
1316132988
Registry record updated Mar 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
H DOUGLAS HORNBECK
Practice address
4510 Collins Blvd
Suite 4
Ashtabula, OH 44004-6954
Phone
(330) 270-5454
Fax
(330) 270-0567
NPI assigned
Sep 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2008

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

Authorized official

Name
H Douglas Hornbeck, MSSA
Title
Owner
Phone
(330) 270-5454

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

4510 Collins Blvd
Suite 4
Ashtabula, OH 44004-6954

Mailing address

PO Box 881
Ashtabula, OH 44005-0881
Phone (440) 992-9777

Other identifiers 2

IdentifierTypeStateIssuer
000000199668OtherOHANTHEM
SP00131OtherOHMEDICARE PTAN

National Provider Directory

National Provider Directory
Tax ID family
H Douglas Hornbeck2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4632 Main Ave
Ste 234
Ashtabula, OH 44004
Phone (440) 992-9777

NPI Registry JSON

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

{
    "created_epoch": "1189123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205107200000",
    "number": "1316132988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 881",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440050881",
            "telephone_number": "440-992-9777",
            "fax_number": "440-992-9683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4510 COLLINS BLVD",
            "address_2": "SUITE 4",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440046954",
            "telephone_number": "330-270-5454",
            "fax_number": "330-270-0567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "H DOUGLAS HORNBECK",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-07",
        "last_updated": "2008-03-10",
        "status": "A",
        "authorized_official_last_name": "HORNBECK",
        "authorized_official_first_name": "H DOUGLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-270-5454",
        "authorized_official_credential": "MSSA"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000199668",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "SP00131",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashtabula, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2008; 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.