Individual provider Active NPI

Eldora L Lazaroff, NP

  • Nurse Practitioner
  • Canton, OH
National Provider Identifier
1538377080
Registry record updated Apr 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN187782 Issued in OH
Practice address
5000 Higbee Ave NW
Canton, OH 44718-2522
Phone
(330) 493-0313
NPI assigned
May 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN187782 OH Primary

Addresses

Primary practice location

5000 Higbee Ave NW
Canton, OH 44718-2522

Mailing address

4245 Skycrest Dr NW
Canton, OH 44718-2149
Phone (330) 493-0277

Other identifiers 1

IdentifierTypeStateIssuer
LANP07652MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN187782OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Stark County Women's Clinic Inc CurrentSince Jan 25, 2010 Accepting new patients

Locations

5000 Higbee Ave NW
Canton, OH 44718
Phone (330) 493-0313

4347 Portage St NW
Ste 102
North Canton, OH 44720

Organizations & group practices 1

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": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365724800000",
    "number": "1538377080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4245 SKYCREST DR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182149",
            "telephone_number": "330-493-0277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 HIGBEE AVE NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182522",
            "telephone_number": "330-493-0313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZAROFF",
        "first_name": "ELDORA",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-18",
        "last_updated": "2013-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "RN187782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LANP07652",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.