Individual provider Active NPI

Tara Medina Salazar, LPN

  • Licensed Practical Nurse
  • Elyria, OH
National Provider Identifier
1578955829
Registry record updated Feb 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN.140944.M-IV Issued in OH
Practice address
347 Midway Blvd Ste 110
Elyria, OH 44035-2496
Phone
(330) 324-5555
NPI assigned
Feb 24, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2015

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.140944.M-IV OH Primary

Addresses

Primary practice location

347 Midway Blvd Ste 110
Elyria, OH 44035-2496

Mailing address

525 Georgetown Ave Apt G28
Elyria, OH 44035-3863
Phone (330) 502-9122

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.140944.M-IVOHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1424736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424736000000",
    "number": "1578955829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 GEORGETOWN AVE APT G28",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440353863",
            "telephone_number": "330-502-9122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "347 MIDWAY BLVD STE 110",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440352496",
            "telephone_number": "330-324-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALAZAR",
        "first_name": "TARA",
        "middle_name": "MEDINA",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-24",
        "last_updated": "2015-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN.140944.M-IV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elyria, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2015; 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.