Ohio Permanente Medical Group Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

OHIO PERMANENTE MEDICAL GROUP INC

Practice address

12301 Snow Rd
Parma, OH 44130-1002

Phone

(216) 265-8810

Fax

(216) 265-8890

NPI assigned

Sep 19, 2006

Last updated

Feb 21, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Marilyn Praznik

Title

Treasurer Cfo Senior Business Execu

Phone

(216) 623-8783

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1158624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203552000000",
    "number": "1023115540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 LAKESIDE AVENUE",
            "address_2": "SUITE 1200",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44114",
            "telephone_number": "216-623-8783",
            "fax_number": "216-623-8776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12301 SNOW RD",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "441301002",
            "telephone_number": "216-265-8810",
            "fax_number": "216-265-8890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OHIO PERMANENTE MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-19",
        "last_updated": "2008-02-21",
        "status": "A",
        "authorized_official_last_name": "PRAZNIK",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_title_or_position": "TREASURER CFO SENIOR BUSINESS EXECU",
        "authorized_official_telephone_number": "216-623-8783"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0211372",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Parma, OH
• Providers in Parma, OH by specialty
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2008; 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.