Individual provider Active NPI

Barbara Lavogue, FNP

  • Family Nurse Practitioner
  • Lakewood, OH
National Provider Identifier
1659653582
Registry record updated Jul 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
12573NP Issued in OH
Practice address
1439 W Clifton Blvd
Lakewood, OH 44107-3308
Phone
(860) 559-2485
Fax
(440) 934-6147
NPI assigned
Sep 16, 2011
Last updated
Jul 23, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 12573NP OH Primary

Addresses

Primary practice location

1439 W Clifton Blvd
Lakewood, OH 44107-3308

Mailing address

1439 W Clifton Blvd
Lakewood, OH 44107-3308
Phone (860) 559-2485

Other identifiers 2

IdentifierTypeStateIssuer
H036360OtherOHMEDICARE-(P-TAN)
0058385MedicaidOH

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
12573NPOHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Elite NP, LLC 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, 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": "1316131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406073600000",
    "number": "1659653582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1439 W CLIFTON BLVD",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441073308",
            "telephone_number": "860-559-2485",
            "fax_number": "440-934-6147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1439 W CLIFTON BLVD",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441073308",
            "telephone_number": "860-559-2485",
            "fax_number": "440-934-6147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVOGUE",
        "first_name": "BARBARA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-16",
        "last_updated": "2014-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "12573NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE-(P-TAN)",
            "identifier": "H036360",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0058385",
            "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 23, 2014; 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.