Individual provider Active NPI

Debora L Livengood, CCC-SLP

  • Speech-Language Pathologist
  • North Canton, OH
National Provider Identifier
1740458777
Registry record updated Jun 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP.6085 Issued in OH
Practice address
7235 Whipple Ave NW
North Canton, OH 44720-7137
Phone
(330) 498-8200
NPI assigned
Feb 12, 2008
Last updated
Jun 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP.6085 OH Primary

Addresses

Primary practice location

7235 Whipple Ave NW
North Canton, OH 44720-7137

Mailing address

10430 Locust Grove Dr
Chardon, OH 44024-8868
Phone (440) 286-8141

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150331001189 OH Practitioner - Qualified Speech Language Pathologist 0941527956 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aegis Group Practice LLCGroup PAC ID 5193036432, 399 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

501 Chardon Windsor Rd
Chardon, OH 44024-8944
Phone (800) 444-6845

5277 Chillicothe Rd
Chagrin Falls, OH 44022-4334
Phone (440) 557-1189

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SP.6085OHMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Aegis Group Practice LLC Speech-Language Pathologist Current Accepting new patients
Aegis Group Practice LLC Speech-Language Pathologist CurrentSince Feb 25, 2022 Accepting new patients
Aegis Group Practice LLC Speech-Language Pathologist CurrentSince Feb 25, 2022 Accepting new patients

Locations

4933 Old Greenwood Rd
Fort Smith, AR 72903

501 Chardon Windsor Rd
Chardon, OH 44024
Phone (440) 286-2277

Organizations & group practices 4

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": "1202774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718496000000",
    "number": "1740458777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10430 LOCUST GROVE DR",
            "city": "CHARDON",
            "state": "OH",
            "postal_code": "440248868",
            "telephone_number": "440-286-8141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7235 WHIPPLE AVE NW",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447207137",
            "telephone_number": "330-498-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVENGOOD",
        "first_name": "DEBORA",
        "middle_name": "L",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-12",
        "last_updated": "2024-06-16",
        "certification_date": "2024-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP.6085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.