Active NPI
Robert Formoso, B.A., BC-HIS
- Hearing Instrument Specialist
- Medina, OH
National Provider Identifier
1811276389
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hearing Instrument Specialist
- License
- 2864
- Practice address
- 3443 Medina Rd
Suite 101a
Medina, OH 44256-5360 - Phone
- (330) 722-3900
- NPI assigned
- Aug 15, 2011
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Hearing Instrument Specialist | 237700000X | 2864 | OH | Primary |
Addresses
Primary practice location
3443 Medina Rd
Suite 101a
Medina, OH 44256-5360
Mailing address
3443 Medina Rd
Suite 101a
Medina, OH 44256-5360
Phone (330) 722-3900
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
- Bachelor of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2864 | OH | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1313366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1381190400000",
"number": "1811276389",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3443 MEDINA RD",
"address_2": "SUITE 101A",
"city": "MEDINA",
"state": "OH",
"postal_code": "442565360",
"telephone_number": "330-722-3900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3443 MEDINA RD",
"address_2": "SUITE 101A",
"city": "MEDINA",
"state": "OH",
"postal_code": "442565360",
"telephone_number": "330-722-3900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORMOSO",
"first_name": "ROBERT",
"credential": "B.A., BC-HIS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-08-15",
"last_updated": "2013-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "OH",
"license": "2864",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medina, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.