Individual provider Active NPI

Lyubov Zaverukha

  • Community Health Worker
  • Meridian, ID
National Provider Identifier
1811430770
Registry record updated Nov 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
OTA-1035 Issued in ID
Practice address
4933 W Astonte St
Meridian, ID 83646-7101
Phone
(208) 284-8148
NPI assigned
Nov 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X OTA-1035 ID Primary

Addresses

Primary practice location

4933 W Astonte St
Meridian, ID 83646-7101

Mailing address

4933 W Astonte St
Meridian, ID 83646-7101

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

LicenseStateTypeSpecialty
OTA-1035IDMDCommunity Health Worker

NPI Registry JSON

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

{
    "created_epoch": "1480291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480291200000",
    "number": "1811430770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4933 W ASTONTE ST",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836467101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4933 W ASTONTE ST",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836467101",
            "telephone_number": "208-284-8148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAVERUKHA",
        "first_name": "LYUBOV",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-28",
        "last_updated": "2016-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "ID",
            "license": "OTA-1035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2016; 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.