Active NPI
Linda Detamore
- School Registered Nurse
- Canton, OH
National Provider Identifier
1700285061
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Registered Nurse
- License
- RN. 154135
- Practice address
- 3057 Cleveland Ave SW
Canton, OH 44707-3625 - Phone
- (330) 484-9690
- Fax
- (330) 484-9607
- NPI assigned
- Aug 22, 2014
- Last updated
- Aug 22, 2014
- 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 |
|---|---|---|---|---|
| School Registered Nurse | 163WS0200X | RN. 154135 | OH | Primary |
Addresses
Primary practice location
3057 Cleveland Ave SW
Canton, OH 44707-3625
Mailing address
3057 Cleveland Ave SW
Canton, OH 44707-3625
Phone (330) 484-9690
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 |
|---|---|---|---|
| RN. 154135 | OH | MD | School Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1408665600000",
"number": "1700285061",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3057 CLEVELAND AVE SW",
"city": "CANTON",
"state": "OH",
"postal_code": "447073625",
"telephone_number": "330-484-9690",
"fax_number": "330-484-9607"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3057 CLEVELAND AVE SW",
"city": "CANTON",
"state": "OH",
"postal_code": "447073625",
"telephone_number": "330-484-9690",
"fax_number": "330-484-9607"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DETAMORE",
"first_name": "LINDA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-08-22",
"last_updated": "2014-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "163WS0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, School",
"state": "OH",
"license": "RN. 154135",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.