MEDICARE: LAVENDER CHEYENNE DORSEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator		OH

General Provider Information

NPI Number	:	1447102819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAVENDER CHEYENNE DORSEY

Provider Business Mailing Address
First Line	:	13089 PRINCE GEORGES AVE NW
Second Line	:
City	:	UNIONTOWN
State	:	OH
Zip	:	44685-7320
Country	:	US
Telephone Number	:	762-822-4689
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 30TH ST NW
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44709-2902
Country	:	US
Telephone Number	:	330-438-3013
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/10/2026
Last Update Date	:	02/10/2026

Similar Medicare Providers

1174831218 — CANTON PHYSICAL MEDICARE, LLC
Practice Location Address:

2050 CUMMING HWY , SUITE 100
CANTON, GA
30114-8614

Practice Phone: 770-345-9600
Practice Fax:

1689411480 — DIANE WRIGHT
Practice Location Address:

800 30TH ST NW
CANTON, OH
44709-2902

Practice Phone: 330-438-2400
Practice Fax:

1841613247 — GENOA HEALTHCARE LLC
Practice Location Address:

800 30TH ST NW STE P
CANTON, OH
44709-2902

Practice Phone: 330-451-6164
Practice Fax: 330-456-2674

1265399190 — TASHEI QUANEK HERRING
Practice Location Address:

800 30TH ST NW
CANTON, OH
44709-2902

Practice Phone: 330-438-2400
Practice Fax: 330-438-3003

1386503886 — CAROLINE GRACE YEARGIN
Practice Location Address:

800 30TH ST NW
CANTON, OH
44709-2902

Practice Phone: 330-438-2400
Practice Fax:

1851242176 — ANGELENA THOMPSON
Practice Location Address:

800 30TH ST NW
CANTON, OH
44709-2902

Practice Phone: 330-438-2400
Practice Fax: 330-438-3003

Directions to “ LAVENDER CHEYENNE DORSEY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.