Organization Active NPI

Suburban Neurodiagnostic Services

  • Neurology Physician
  • Warrensville Heights, OH
National Provider Identifier
1104870120
Registry record updated Jan 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
SUBURBAN NEURODIAGNOSTIC SERVICES
Practice address
4180 Warrensville Center Rd
Warrensville Heights, OH 44122
Phone
(440) 777-6300
Fax
(440) 777-2330
NPI assigned
May 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2009

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

Authorized official

Name
Harold Mars, MDNPI 1003900812
Title
Medical Director
Phone
(440) 831-6085

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

4180 Warrensville Center Rd
Warrensville Heights, OH 44122

Mailing address

7500 Old Oak Blvd
Middleburg HTS., OH 44130-0000
Phone (440) 777-6300

Other identifiers 1

IdentifierTypeStateIssuer
0755688MedicaidOH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233273600000",
    "number": "1104870120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 OLD OAK BLVD",
            "city": "MIDDLEBURG HTS.",
            "state": "OH",
            "postal_code": "441300000",
            "telephone_number": "440-777-6300",
            "fax_number": "440-777-2330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4180 WARRENSVILLE CENTER RD",
            "city": "WARRENSVILLE HEIGHTS",
            "state": "OH",
            "postal_code": "44122",
            "telephone_number": "440-777-6300",
            "fax_number": "440-777-2330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBURBAN NEURODIAGNOSTIC SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-22",
        "last_updated": "2009-01-30",
        "status": "A",
        "authorized_official_last_name": "MARS",
        "authorized_official_first_name": "HAROLD",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "440-831-6085",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0755688",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warrensville Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2009; 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.