NPIMap

Organization Active NPI

Marymount Hospital

  • Registered Dietitian
  • Cleveland, OH
National Provider Identifier
1043367618
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
3073 Issued in OH
Legal business name
MARYMOUNT HOSPITAL
Practice address
12300 McCracken Rd
Suite 211
Cleveland, OH 44125-2914
Phone
(216) 584-4372
NPI assigned
Jan 4, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Mike Benich
Title
Controller
Phone
(216) 587-8361

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X 3073 OH Primary

Addresses

Primary practice location

12300 McCracken Rd
Suite 211
Cleveland, OH 44125-2914

Mailing address

12300 McCracken Rd
Loretto Building
Garfield Heights, OH 44125-2914
Phone (216) 581-0500

National Provider Directory

National Provider Directory
Tax ID family
Marymount Pathology7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

12300 McCracken Rd
Ste 211
Garfield Heights, OH 44125
Phone (216) 584-4372

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043367618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12300 MCCRACKEN RD",
            "address_2": "LORETTO BUILDING",
            "city": "GARFIELD HEIGHTS",
            "state": "OH",
            "postal_code": "441252914",
            "telephone_number": "216-581-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12300 MCCRACKEN RD",
            "address_2": "SUITE 211",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441252914",
            "telephone_number": "216-584-4372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYMOUNT HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BENICH",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "216-587-8361",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "OH",
            "license": "3073",
            "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 Aug 22, 2020; 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.