Active NPI
Deborah D. Young, HEARING AID PROVIDER
- Hearing Aid Equipment
- Lakewood, OH
National Provider Identifier
1619008208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hearing Aid Equipment
- License
- 00636
- Practice address
- 14233 Detroit Ave
Lakewood, OH 44107-4461 - Phone
- (216) 533-5403
- NPI assigned
- Mar 8, 2007
- Last updated
- Jul 9, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hearing Aid Equipment | 332S00000X | 00636 | OH | Primary |
Addresses
Primary practice location
14233 Detroit Ave
Lakewood, OH 44107-4461
Mailing address
12700 Lake Ave
#714
Lakewood, OH 44107-1576
Phone (216) 221-0085
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0954187 | Medicaid | OH |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 00636 | OH | MD | Hearing Aid Equipment |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1619008208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12700 LAKE AVE",
"address_2": "#714",
"city": "LAKEWOOD",
"state": "OH",
"postal_code": "441071576",
"telephone_number": "216-221-0085",
"fax_number": "216-712-6201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14233 DETROIT AVE",
"city": "LAKEWOOD",
"state": "OH",
"postal_code": "441074461",
"telephone_number": "216-533-5403"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "DEBORAH",
"middle_name": "D.",
"name_prefix": "Mrs.",
"credential": "HEARING AID PROVIDER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-08",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "332S00000X",
"taxonomy_group": "",
"desc": "Hearing Aid Equipment",
"state": "OH",
"license": "00636",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0954187",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lakewood, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.