Organization Active NPI

Kaiser Foundation Health Plan

Doing business as Cleveland Heights Medical Offices Laboratory

  • Clinical Medical Laboratory
  • Cleveland Heights, OH
National Provider Identifier
1114093895
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
KAISER FOUNDATION HEALTH PLAN
Doing business as
Cleveland Heights Medical Offices Laboratory
Practice address
10 Severance Circle
Cleveland Heights, OH 44118
Phone
(216) 265-8844
Fax
(216) 265-8890
NPI assigned
Nov 27, 2006
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
Thomas Revis
Title
VP Cfo
Phone
(216) 265-8844

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

10 Severance Circle
Cleveland Heights, OH 44118

Mailing address

12301 Snow Road
Parma, OH 44130
Phone (216) 265-8844

Other identifiers 1

IdentifierTypeStateIssuer
0211372MedicaidOH

Other names 1

  • Cleveland Heights Medical Offices Laboratory Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2107149Metrohealth Cleveland Heights-Path Lab10 Severance Circle, Cleveland Heights, OH 44118AccreditationJun 20, 2027

National Provider Directory

National Provider Directory
Tax ID family
Kaiser Foundation185 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 3

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

NPI Registry JSON

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114093895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12301 SNOW ROAD",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "44130",
            "telephone_number": "216-265-8844",
            "fax_number": "216-265-8890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 SEVERANCE CIRCLE",
            "city": "CLEVELAND HEIGHTS",
            "state": "OH",
            "postal_code": "44118",
            "telephone_number": "216-265-8844",
            "fax_number": "216-265-8890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER FOUNDATION HEALTH PLAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "REVIS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "VP CFO",
        "authorized_official_telephone_number": "216-265-8844"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0211372",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cleveland Heights Medical Offices Laboratory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cleveland Heights, 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.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.