Kelly L Durbin, M.A.,C.C.C.-A

Primary specialty

AudiologistTaxonomy code 231H00000X

License

A-01109 Issued in OH

Practice address

25761 Lorain Rd
3Rd FL
North Olmsted, OH 44070-3327

Phone

(440) 779-1112

NPI assigned

Jul 28, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1217203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412899200000",
    "number": "1457516593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25761 LORAIN RD",
            "address_2": "3RD FL",
            "city": "NORTH OLMSTED",
            "state": "OH",
            "postal_code": "440703327",
            "telephone_number": "440-779-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25761 LORAIN RD",
            "address_2": "3RD FL",
            "city": "NORTH OLMSTED",
            "state": "OH",
            "postal_code": "440703327",
            "telephone_number": "440-779-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURBIN",
        "first_name": "KELLY",
        "middle_name": "L",
        "credential": "M.A.,C.C.C.-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-28",
        "last_updated": "2014-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OH",
            "license": "A-01109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "4246481",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD PTAN",
            "identifier": "P00681443",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0972309",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2085523",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2085541",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• E.N.T. and Allergy Health Services, Inc.
• Ashraf H El Dabh, MD
• Elderhood Community Services

• Audiologist in North Olmsted, OH
• Providers in North Olmsted, OH by specialty
• Audiologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2014; 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.