Individual provider Active NPI

Jill Erin Lagerstedt, M.A./CCC-A

  • Audiologist
  • Cleveland, OH
National Provider Identifier
1689685703
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
A01196 Issued in OH
Practice address
10701 East Blvd
Cleveland, OH 44106-1702
Phone
(216) 421-3047
Fax
(216) 707-5958
NPI assigned
Aug 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X A01196 OH Primary

Addresses

Primary practice location

10701 East Blvd
Cleveland, OH 44106-1702

Mailing address

11530 Riding TRL
Painesville, OH 44077-8973

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
A01196OHMDAudiologist

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689685703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11530 RIDING TRL",
            "city": "PAINESVILLE",
            "state": "OH",
            "postal_code": "440778973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10701 EAST BLVD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441061702",
            "telephone_number": "216-421-3047",
            "fax_number": "216-707-5958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAGERSTEDT",
        "first_name": "JILL",
        "middle_name": "ERIN",
        "credential": "M.A./CCC-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OH",
            "license": "A01196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, 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.

Verify at the official NPI Registry.