Individual provider Active NPI

Deborah K Malone

  • Licensed Practical Nurse
  • Batavia, OH
National Provider Identifier
1578055752
Registry record updated Jun 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LPN.163068.MEDS-IV Issued in OH
Practice address
1088 Wasserman Way
Batavia, OH 45103
Phone
(513) 735-8100
Fax
(513) 354-7115
NPI assigned
Jun 4, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN.163068.MEDS-IV OH Primary

Addresses

Primary practice location

1088 Wasserman Way
Batavia, OH 45103

Mailing address

1501 Madison Rd
Walnut Hills, OH 45206-1706
Phone (513) 354-7100

Other practice location 1

1501 Madison Rd
Walnut Hills, OH 45206-1706
Phone (513) 354-7100

Other identifiers 1

IdentifierTypeStateIssuer
00000OtherOHLICENSURE BOARD

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
LPN.163068.MEDS-IVOHMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Clermont Recovery Center, Inc. Past Accepting new patients

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": "1528070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528070400000",
    "number": "1578055752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 MADISON RD",
            "city": "WALNUT HILLS",
            "state": "OH",
            "postal_code": "452061706",
            "telephone_number": "513-354-7100",
            "fax_number": "513-354-7115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1088 WASSERMAN WAY",
            "city": "BATAVIA",
            "state": "OH",
            "postal_code": "45103",
            "telephone_number": "513-735-8100",
            "fax_number": "513-354-7115"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 Madison Rd",
            "address_purpose": "LOCATION",
            "city": "Walnut Hills",
            "state": "OH",
            "postal_code": "452061706",
            "country_code": "US",
            "telephone_number": "513-354-7100",
            "fax_number": "513-354-7115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALONE",
        "first_name": "DEBORAH",
        "middle_name": "K",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-04",
        "last_updated": "2018-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "LPN.163068.MEDS-IV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSURE BOARD",
            "identifier": "00000",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Batavia, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2018; 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.