Active NPI
Paula Jean Hackley IV, OTRL
- Specialist
- Cleveland, OH
National Provider Identifier
1952456568
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- OT-005746
- Practice address
- 10011 Euclid Ave
Cleveland, OH 44106-4701 - Phone
- (216) 791-8363
- Fax
- (216) 791-2539
- NPI assigned
- Jan 24, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Specialist | 174400000X | OT-005746 | OH | Primary |
Addresses
Primary practice location
10011 Euclid Ave
Cleveland, OH 44106-4701
Mailing address
3303 Linden Rd Apt 609
Rocky River, OH 44116-4103
Phone (440) 356-8715
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 340753561030 | Other | OH | CARESOURCE ID |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT-005746 | OH | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1952456568",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3303 LINDEN RD APT 609",
"city": "ROCKY RIVER",
"state": "OH",
"postal_code": "441164103",
"telephone_number": "440-356-8715"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10011 EUCLID AVE",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441064701",
"telephone_number": "216-791-8363",
"fax_number": "216-791-2539"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HACKLEY",
"first_name": "PAULA",
"middle_name": "JEAN",
"name_suffix": "IV",
"credential": "OTRL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "OH",
"license": "OT-005746",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARESOURCE ID",
"identifier": "340753561030",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.