Active NPI
Ivy Roberta Boyle
- Child & Adolescent Psychiatry Physician
- Shaker Heights, OH
National Provider Identifier
1649318189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- 35.032344
- Practice address
- 2735 Ashley Rd
Shaker Heights, OH 44122-1922 - Phone
- (216) 932-3587
- Fax
- (216) 321-8859
- NPI assigned
- Feb 4, 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 |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | 35.032344 | OH | Primary |
Addresses
Primary practice location
2735 Ashley Rd
Shaker Heights, OH 44122-1922
Mailing address
2735 Ashley Rd
Shaker Heights, OH 44122-1922
Phone (216) 932-3587
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 |
|---|---|---|---|
| 35.032344 | OH | MD | Child & Adolescent Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1649318189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2735 ASHLEY RD",
"city": "SHAKER HEIGHTS",
"state": "OH",
"postal_code": "441221922",
"telephone_number": "216-932-3587",
"fax_number": "216-321-8859"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2735 ASHLEY RD",
"city": "SHAKER HEIGHTS",
"state": "OH",
"postal_code": "441221922",
"telephone_number": "216-932-3587",
"fax_number": "216-321-8859"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOYLE",
"first_name": "IVY",
"middle_name": "ROBERTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "OH",
"license": "35.032344",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shaker Heights, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.