Individual provider Active NPI

Winifred Mary Neugebauer, LPN

  • Licensed Practical Nurse
  • Canton, OH
National Provider Identifier
1578074639
Registry record updated Oct 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN.081241 Issued in OH
Practice address
1620 Market Ave S
Canton, OH 44707
Phone
(330) 458-0393
NPI assigned
Oct 17, 2017
Last updated
Oct 17, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2017

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 PN.081241 OH Primary

Addresses

Primary practice location

1620 Market Ave S
Canton, OH 44707

Mailing address

2111 Ganyard Rd
Akron, OH 44313-6013
Phone (330) 867-2019

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
PN.081241OHMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Academy Management Past Accepting new patients
Summit Academy Community School for Alternative Learners 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1508198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508198400000",
    "number": "1578074639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 GANYARD RD",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443136013",
            "telephone_number": "330-867-2019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 MARKET AVE S",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "44707",
            "telephone_number": "330-458-0393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEUGEBAUER",
        "first_name": "WINIFRED",
        "middle_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-17",
        "last_updated": "2017-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN.081241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2017; 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.