Active NPI
Ann Cook Van de Walle, M.ED.
- Student in an Organized Health Care Education/Training Program
- Independence, OH
National Provider Identifier
1104558386
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 5905 Brecksville Rd
Independence, OH 44131-1517 - Phone
- (216) 524-4673
- NPI assigned
- Jun 27, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
5905 Brecksville Rd
Independence, OH 44131-1517
Mailing address
3063 Forest Dr
Cleveland, OH 44124-5125
Phone (216) 544-4751
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
- Credentials
- Master of Education
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cornerstone of Hope Inc | Current | Accepting new patients |
Locations
5905 Brecksville Rd
Independence, OH 44131
Phone (216) 524-4673
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Clinical Social Worker
- Independence, OH
- NPI 1962805648
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656288000000",
"number": "1104558386",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3063 FOREST DR",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441245125",
"telephone_number": "216-544-4751"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5905 BRECKSVILLE RD",
"city": "INDEPENDENCE",
"state": "OH",
"postal_code": "441311517",
"telephone_number": "216-524-4673"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN DE WALLE",
"first_name": "ANN",
"middle_name": "COOK",
"credential": "M.ED.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-27",
"last_updated": "2022-06-27",
"certification_date": "2022-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Independence, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.