Individual provider Active NPI

Mary Elizabeth Koger

  • Nurse's Aide
  • Cleveland, OH
National Provider Identifier
1033247697
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
320922870804 Issued in OH
Practice address
3717 Barlett Street
Cleveland, OH 44128-4806
Phone
(216) 751-5176
NPI assigned
Mar 2, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X 320922870804 OH Primary

Addresses

Primary practice location

3717 Barlett Street
Cleveland, OH 44128-4806

Mailing address

19200 Roseland Ave
G-349
Euclid, OH 44117-1385
Phone (216) 624-6444

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
320922870804OHMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033247697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19200 ROSELAND AVE",
            "address_2": "G-349",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441171385",
            "telephone_number": "216-624-6444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3717 BARLETT STREET",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441284806",
            "telephone_number": "216-751-5176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOGER",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "OH",
            "license": "320922870804",
            "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 Jul 8, 2007; 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.