Organization Active NPI

Middleburg Heights Podiatry LTD

  • Primary Podiatric Medicine Podiatrist
  • Middleburg Heights, OH
National Provider Identifier
1104921287
Registry record updated Jun 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
Legal business name
MIDDLEBURG HEIGHTS PODIATRY LTD
Practice address
18660 Bagley Rd
Suite 301
Middleburg Heights, OH 44130-3483
Phone
(440) 243-1473
Fax
(440) 243-1476
NPI assigned
Sep 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2021

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

Authorized official

Name
Robin Brown
Title
Access Manager
Phone
(440) 238-8843

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213EP1101X OH Primary

Addresses

Primary practice location

18660 Bagley Rd
Suite 301
Middleburg Heights, OH 44130-3483

Mailing address

18660 Bagley Rd
Suite 301
Middleburg Heights, OH 44130-3483
Phone (440) 243-1473

Other identifiers 1

IdentifierTypeStateIssuer
2794712MedicaidOH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623024000000",
    "number": "1104921287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18660 BAGLEY RD",
            "address_2": "SUITE 301",
            "city": "MIDDLEBURG HEIGHTS",
            "state": "OH",
            "postal_code": "441303483",
            "telephone_number": "440-243-1473",
            "fax_number": "440-243-1476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18660 BAGLEY RD",
            "address_2": "SUITE 301",
            "city": "MIDDLEBURG HEIGHTS",
            "state": "OH",
            "postal_code": "441303483",
            "telephone_number": "440-243-1473",
            "fax_number": "440-243-1476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLEBURG HEIGHTS PODIATRY LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "ACCESS MANAGER",
        "authorized_official_telephone_number": "440-238-8843"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2794712",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middleburg Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; 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.