Individual provider Active NPI

Candia Kathleen Luby, NURSE PRACTITIONER

  • Adult Health Nurse Practitioner
  • Parma, OH
National Provider Identifier
1770740334
Registry record updated Jun 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
09976 Issued in OH
Practice address
12301 Snow Road
Parma, OH 44133
Phone
(216) 265-4432
Fax
(216) 265-4478
NPI assigned
May 21, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X 149131 OH
Adult Health Nurse Practitioner 363LA2200X 09976 OH Primary

Addresses

Primary practice location

12301 Snow Road
Parma, OH 44133

Mailing address

12301 Snow Road
Parma, OH 44133
Phone (216) 265-4432

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080912000089 OH Practitioner - Nurse Practitioner 3274609441 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149131OHMDMedical-Surgical Registered Nurse
09976OHMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Metrohealth System CurrentSince Mar 1, 2016 Accepting new patients
The Metrohealth System CurrentSince Mar 1, 2016 Accepting new patients

Locations

2500 Metrohealth Dr
Cleveland, OH 44109
Phone (216) 778-2348

12301 Snow Rd
Parma Heights, OH 44130
Phone (216) 285-8810

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433289600000",
    "number": "1770740334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12301 SNOW ROAD",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "44133",
            "telephone_number": "216-265-4432",
            "fax_number": "216-265-4478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12301 SNOW ROAD",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "44133",
            "telephone_number": "216-265-4432",
            "fax_number": "216-265-4478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUBY",
        "first_name": "CANDIA",
        "middle_name": "KATHLEEN",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-21",
        "last_updated": "2015-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "OH",
            "license": "149131",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "09976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parma, OH

Sources for this page

Verify at the official NPI Registry.