Individual provider Active NPI

Angela E Damron, M.A., CCC/A

  • Audiologist
  • Fairlawn, OH
National Provider Identifier
1356428486
Registry record updated Aug 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
A01531 Issued in OH
Practice address
3200 W Market St Ste 108
Fairlawn, OH 44333-3324
Phone
(330) 869-9911
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X A01531 OH Primary

Addresses

Primary practice location

3200 W Market St Ste 108
Fairlawn, OH 44333-3324

Mailing address

3200 W Market St Ste 108
Fairlawn, OH 44333-3324
Phone (330) 869-9911

Other identifiers 1

IdentifierTypeStateIssuer
0105418MedicaidOH

Other names 1

  • Angela E Pratt Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050824000990 OH Practitioner - Qualified Audiologist 1850322371 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
A01531OHMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Audiology Distribution, LLC CurrentSince Jul 1, 2014 Accepting new patients
Hearusa Inc Past Accepting new patients
Belleober Inc Audiologist Past Accepting new patients

Locations

3200 W Market St
Fairlawn, OH 44333
Phone (330) 836-7702

3200 W Market St
Ste 108
Fairlawn, OH 44333
Phone (330) 869-9911

6789 Ridge Rd
Ste 202
Parma, OH 44129
Phone (330) 748-8062

Organizations & group practices 3

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471996800000",
    "number": "1356428486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 W MARKET ST STE 108",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443333324",
            "telephone_number": "330-869-9911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 W MARKET ST STE 108",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443333324",
            "telephone_number": "330-869-9911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMRON",
        "first_name": "ANGELA",
        "middle_name": "E",
        "credential": "M.A., CCC/A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2016-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OH",
            "license": "A01531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0105418",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "PRATT",
            "middle_name": "E",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fairlawn, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.