Individual provider Active NPI

Wanda L Staab, CNP CNS

  • Acute Care Nurse Practitioner
  • Akron, OH
National Provider Identifier
1366461964
Registry record updated Apr 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
NP06552 Issued in OH
Practice address
95 Arch St
Akron, OH 44304-1437
Phone
(330) 376-7000
Fax
(330) 376-1066
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Clinical Nurse Specialist 364SA2200X NP06552 OH
Acute Care Nurse Practitioner 363LA2100X NP06552 OH Primary

Addresses

Primary practice location

95 Arch St
Akron, OH 44304-1437

Mailing address

95 Arch St
Akron, OH 44304-1437
Phone (330) 376-7000

Other identifiers 1

IdentifierTypeStateIssuer
2599568MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051025000779 OH Practitioner - Nurse Practitioner 3870510274 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summa Physicians LLCGroup PAC ID 2961303532, 692 clinicians

Practice addresses (Care Compare)

525 E Market St
Akron, OH 44304-1619

55 Arch St
Suite 1B
Akron, OH 44304-1436
Phone (330) 375-3315

95 Arch St
Suite 215
Akron, OH 44304-1467
Phone (330) 434-4145

Hospital & facility affiliations

  • Summa Health System Hospital, Akron, OH, CCN 360020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Certified Nurse Specialist, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Summa Physicians LLC Current Accepting new patients
Summa Physicians LLC CurrentSince May 1, 2008 Accepting new patients
Summa Physicians LLC Past Accepting new patients
Northeast Ohio Cardiovascular Specialists Inc. Past Accepting new patients
The Heart Group, Inc. Past Accepting new patients

Locations

525 E Market St
Akron, OH 44304
Phone (330) 375-6350

1077 Gorge Blvd
Akron, OH 44310
Phone (234) 312-5691

Interoperability endpoints

  • Direct secure messaging: wstaab19540@summahealth-direct.org

Organizations & group practices 5

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302480000000",
    "number": "1366461964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 ARCH ST",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443041437",
            "telephone_number": "330-376-7000",
            "fax_number": "330-376-1066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 ARCH ST",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443041437",
            "telephone_number": "330-376-7000",
            "fax_number": "330-376-1066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAAB",
        "first_name": "WANDA",
        "middle_name": "L",
        "credential": "CNP CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2011-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "OH",
            "license": "NP06552",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "NP06552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2599568",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

Verify at the official NPI Registry.