NPIMap

Organization Active NPI

The Metrohealth System

Doing business as Metrohealth Professional Group, Metrohealth Medical Ctr

  • Addiction Psychiatry Physician
  • Cleveland, OH
National Provider Identifier
1023436375
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Psychiatry PhysicianTaxonomy code 2084P0802X
Legal business name
THE METROHEALTH SYSTEM
Doing business as
Metrohealth Professional Group, Metrohealth Medical Ctr
Practice address
2500 Metrohealth Drive
Cleveland, OH 44109-1998
Phone
(216) 957-2442
Fax
(216) 957-2404
NPI assigned
Apr 3, 2014
Last updated
May 9, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
THE METROHEALTH SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Authorized official

Name
Mr. Derrick Hollings
Title
Evp/Cfo
Phone
(216) 778-5716

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Psychiatry Physician 2084P0802X NU Primary

Addresses

Primary practice location

2500 Metrohealth Drive
Cleveland, OH 44109-1998

Mailing address

2500 Metrohealth Drive
Cleveland, OH 44109-1998
Phone (216) 957-2442

Other identifiers 1

IdentifierTypeStateIssuer
0100457MedicaidOH

Other names 1

  • Metrohealth Professional Group, Metrohealth Medical Ctr Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Metrohealth Inpatient M38 organizations share this tax ID, including this one
Part of
Metrohealth Inpatient M

Other organizations with this tax ID 37

Organizations that report the same tax identification number in the National Provider Directory.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1396483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715212800000",
    "number": "1023436375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 METROHEALTH DRIVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441091998",
            "telephone_number": "216-957-2442",
            "fax_number": "216-957-2404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 METROHEALTH DRIVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441091998",
            "telephone_number": "216-957-2442",
            "fax_number": "216-957-2404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE METROHEALTH SYSTEM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE METROHEALTH SYSTEM",
        "enumeration_date": "2014-04-03",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A",
        "authorized_official_last_name": "HOLLINGS",
        "authorized_official_first_name": "DERRICK",
        "authorized_official_title_or_position": "EVP/CFO",
        "authorized_official_telephone_number": "216-778-5716",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0100457",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Metrohealth Professional Group, Metrohealth Medical Ctr",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Metrohealth Professional Group, Metrohealth Medical Ctr",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 9, 2024; 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.