Active NPI
Stacie Mencke
- Other Technician
- Lyndhurst, OH
National Provider Identifier
1972999787
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- License
- 33.015830
- Practice address
- 5195 Mayfield Rd
Suite 10
Lyndhurst, OH 44124-2464 - Phone
- (440) 720-1810
- Fax
- (440) 720-1814
- NPI assigned
- Apr 8, 2015
- 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 |
|---|---|---|---|---|
| Other Technician | 247200000X | 33.015830 | OH | Primary |
Addresses
Primary practice location
5195 Mayfield Rd
Suite 10
Lyndhurst, OH 44124-2464
Mailing address
5195 Mayfield Rd
Suite 10
Lyndhurst, OH 44124-2464
Phone (440) 720-1810
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
| License | State | Type | Specialty |
|---|---|---|---|
| 33.015830 | OH | MD | Other Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1428451200000",
"number": "1972999787",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5195 MAYFIELD RD",
"address_2": "SUITE 10",
"city": "LYNDHURST",
"state": "OH",
"postal_code": "441242464",
"telephone_number": "440-720-1810",
"fax_number": "440-720-1814"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5195 MAYFIELD RD",
"address_2": "SUITE 10",
"city": "LYNDHURST",
"state": "OH",
"postal_code": "441242464",
"telephone_number": "440-720-1810",
"fax_number": "440-720-1814"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENCKE",
"first_name": "STACIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-08",
"last_updated": "2015-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "OH",
"license": "33.015830",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lyndhurst, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.