Individual provider Active NPI

Jodi Lynn Skrovan, M.A.,CCC/A

  • Audiologist
  • Dayton, OH
National Provider Identifier
1487279766
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
A.01091 Issued in OH
Practice address
110 N Main St Ste 350
Dayton, OH 45402-3735
Phone
(937) 499-8263
NPI assigned
Jun 11, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X A.01091 OH Primary

Addresses

Primary practice location

110 N Main St Ste 350
Dayton, OH 45402-3735

Mailing address

6724 Serrell LN
Dayton, OH 45424-8701
Phone (937) 707-8267

Other practice location 1

210 S Market St Ste A
Troy, OH 45373-4639
Phone (937) 308-7000

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Dayton Direct Premier Physician Network, LLC

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
A.01091OHMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Onhealthcare, LLC Past Accepting new patients
Upper Valley Hearing & Balance Inc PastSince Jul 5, 2007 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": "1591833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1487279766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6724 SERRELL LN",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454248701",
            "telephone_number": "937-707-8267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 N MAIN ST STE 350",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454023735",
            "telephone_number": "937-499-8263"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "210 S Market St Ste A",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "OH",
            "postal_code": "453734639",
            "country_code": "US",
            "telephone_number": "937-308-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SKROVAN",
        "first_name": "JODI",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "M.A.,CCC/A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-11",
        "last_updated": "2023-11-27",
        "certification_date": "2020-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OH",
            "license": "A.01091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Dayton",
            "affiliation": "Y",
            "endpointDescription": "work email",
            "affiliationName": "Premier Physician Network, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "110 N Main St Ste 350",
            "city": "Dayton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454023735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.