Vaquet A Shomo-Brown, CNP
Individual provider Active NPI Nurse Practitioner · Cleveland, OH
NPI 1124226865 · NPPES record last updated Mar 23, 2026
Key facts
- NPI
- 1124226865
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- APRN.CNP.020411 (OH)
- Practice address
- 12205 Forest Ave
Cleveland, OH 44120-2931 - Phone
- (216) 551-2411
- Fax
- (216) 428-7904
- NPI assigned
- Jul 3, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Wissam Khoury DPM LLC
Practice addresses (Care Compare)
2475 E 22ND St
Suite 120
Cleveland, OH 44115-3221
Phone (216) 367-9444
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170606002586 | OH | Practitioner - Nurse Practitioner | 9032486493 |
Reassigns benefits to 4 organizations Practice locations: Painesville, OH |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wissam Khoury DPM LLC | Current |
Accepting new patients | |
| Signature Health, Inc. | Current |
Accepting new patients | |
| Shomo Solutions LLC | Current |
Accepting new patients | |
| Signature Health Inc | Current |
Accepting new patients | |
| Santibanez Pac Ohio Inc | Nurse Practitioner | Current |
Accepting new patients |
Locations
400 E Rivulon Blvd
Ste 103
Gilbert, AZ 85297
2475 E 22nd St
Ste 120
Cleveland, OH 44115
Phone (216) 367-9444
21100 Southgate Park Blvd
Maple Heights, OH 44137
Phone (216) 663-6100
7232 Justin Way
Mentor, OH 44060
Phone (440) 488-2855
275 E Sunset Dr
Rittman, OH 44270
Phone (330) 927-2060
38876 Mentor Ave
Willoughby, OH 44094
Phone (440) 954-3333
38882 Mentor Ave
Willoughby, OH 44094
Interoperability endpoints
- vshomobrown578374@direct.ochin.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | APRN.CNP.020411 | OH | Yes |
Addresses
Primary practice location
12205 Forest Ave
Cleveland, OH 44120-2931
Mailing address
12205 Forest Ave
Cleveland, OH 44120-2931
Phone (216) 551-2411
Other names
- Vaquet A Shomo-Brown
Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 23, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.