Individual provider Active NPI

Romello Laquan Davon Norton

  • Contractor
  • Cleveland, OH
National Provider Identifier
1104610211
Registry record updated Apr 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
VM557804 Issued in OH
Practice address
6408 Carl Ave
2
Cleveland, OH 44103
Phone
(216) 820-0825
NPI assigned
Apr 5, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X VM557804 OH Primary

Addresses

Primary practice location

6408 Carl Ave
2
Cleveland, OH 44103

Mailing address

6408 Carl Ave
3
Cleveland, OH 44103
Phone (216) 820-0825

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
VM557804OHMDContractor

NPI Registry JSON

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

{
    "created_epoch": "1743811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743811200000",
    "number": "1104610211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6408 CARL AVE",
            "address_2": "3",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44103",
            "telephone_number": "216-820-0825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6408 CARL AVE",
            "address_2": "2",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44103",
            "telephone_number": "216-820-0825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORTON",
        "first_name": "ROMELLO",
        "middle_name": "LAQUAN DAVON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-04-05",
        "last_updated": "2025-04-05",
        "certification_date": "2025-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "OH",
            "license": "VM557804",
            "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 Apr 5, 2025; 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.