Individual provider Active NPI

Denise Alexandra Roberts, M.S., CCC/A

  • Audiologist
  • Willoughby, OH
National Provider Identifier
1366461105
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
A01314 Issued in OH
Practice address
34302 Euclid Ave
Unit #4
Willoughby, OH 44094-3334
Phone
(440) 942-3480
Fax
(440) 942-3451
NPI assigned
Jul 19, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 4

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.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A01314OHMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
American Hearing Centers, Inc. Past Accepting new patients
Audiology Distribution, LLC Past Accepting new patients
Better Hearing Centers, Inc. Past Accepting new patients
Hearusa Inc Past Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X A01314 OH Primary

Addresses

NPPES NPI Registry

Primary practice location

34302 Euclid Ave
Unit #4
Willoughby, OH 44094-3334

Mailing address

2136 16TH St
Cuyahoga Falls, OH 44223-1932
Phone (330) 929-6621

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
A01314OtherOHLICENSE

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366461105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2136 16TH ST",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "442231932",
            "telephone_number": "330-929-6621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34302 EUCLID AVE",
            "address_2": "UNIT #4",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440943334",
            "telephone_number": "440-942-3480",
            "fax_number": "440-942-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "DENISE",
        "middle_name": "ALEXANDRA",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC/A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OH",
            "license": "A01314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "A01314",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Willoughby, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.