Individual provider Active NPI

Adriane Stana Simovic, LPN

  • Licensed Practical Nurse
  • Cleveland, OH
National Provider Identifier
1023247574
Registry record updated Sep 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN 128075 IV Issued in OH
Practice address
4004 Henritze Ave
Cleveland, OH 44109-3252
Phone
(216) 661-8032
NPI assigned
Jul 6, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN 128075 IV OH Primary

Addresses

Primary practice location

4004 Henritze Ave
Cleveland, OH 44109-3252

Mailing address

4004 Henritze Ave
Cleveland, OH 44109-3252
Phone (216) 661-8032

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
PN 128075 IVOHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1246838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411689600000",
    "number": "1023247574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4004 HENRITZE AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441093252",
            "telephone_number": "216-661-8032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4004 HENRITZE AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441093252",
            "telephone_number": "216-661-8032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMOVIC",
        "first_name": "ADRIANE",
        "middle_name": "STANA",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-06",
        "last_updated": "2014-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN 128075 IV",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 26, 2014; 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.