Individual provider Active NPI

Deborah Kay Nahra, MACCCSLP

  • Speech-Language Pathologist
  • Newark, OH
National Provider Identifier
1376895037
Registry record updated Oct 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3866 Issued in OH
Practice address
1945 Tamarack Rd
Newark, OH 43055-1300
Phone
(740) 349-9777
NPI assigned
Oct 4, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 3866 OH Primary

Addresses

Primary practice location

1945 Tamarack Rd
Newark, OH 43055-1300

Mailing address

6170 Brentcrest Dr
Nashport, OH 43830-9565
Phone (740) 607-2417

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3866OHMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Executive Rehab Services LTD. Past Accepting new patients
Executive Rehab Services Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 2

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": "1349308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349740800000",
    "number": "1376895037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6170 BRENTCREST DR",
            "city": "NASHPORT",
            "state": "OH",
            "postal_code": "438309565",
            "telephone_number": "740-607-2417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1945 TAMARACK RD",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551300",
            "telephone_number": "740-349-9777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAHRA",
        "first_name": "DEBORAH",
        "middle_name": "KAY",
        "name_prefix": "Ms.",
        "credential": "MACCCSLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-04",
        "last_updated": "2012-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "3866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2012; 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.