DDC Clinic for Special Needs Children

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

81033 Issued in OH

Legal business name

DDC CLINIC FOR SPECIAL NEEDS CHILDREN

Practice address

14567 Madison Rd
Middlefield, OH 44062-9499

Phone

(440) 632-1668

Fax

(440) 632-1697

NPI assigned

Jul 8, 2006

Last updated

Sep 30, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Patti Gallagher

Title

Operations Director

Phone

(440) 632-1668

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Heng Wang, M.D., PH.D.

  • Pediatrics Physician
  • Middlefield, OH
  • NPI 1255588406
  Medicare reassignment NPD

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632960000000",
    "number": "1124051842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14567 MADISON RD",
            "city": "MIDDLEFIELD",
            "state": "OH",
            "postal_code": "440629499",
            "telephone_number": "440-632-1668",
            "fax_number": "440-632-1697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14567 MADISON RD",
            "city": "MIDDLEFIELD",
            "state": "OH",
            "postal_code": "440629499",
            "telephone_number": "440-632-1668",
            "fax_number": "440-632-1697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DDC CLINIC FOR SPECIAL NEEDS CHILDREN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-30",
        "status": "A",
        "authorized_official_last_name": "GALLAGHER",
        "authorized_official_first_name": "PATTI",
        "authorized_official_title_or_position": "OPERATIONS DIRECTOR",
        "authorized_official_telephone_number": "440-632-1668"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "OH",
            "license": "81033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2323980",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Adam Michael Cramer, PT, DPT
• John Cray
• Douglas Mark Dalton, R.N., B.S.N.
• Gaye Marie Dalton, L.P.N., B.S.
• Tracy M Deak
• Gino Desantis
• Julie Anna Dragojevic
• Daria M Dreboty-Cerimele, M.D.
• Dual County Eyecare LLC

• Primary Care Clinic/Center in Middlefield, OH
• Providers in Middlefield, OH by specialty
• Primary Care Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.