NPIMap

Organization Active NPI

Mycare Clinic LLC

  • Nurse Practitioner
  • Strongsville, OH
National Provider Identifier
1124488705
Registry record updated Mar 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
MYCARE CLINIC LLC
Practice address
16224 Pearl Rd
Strongsville, OH 44136-6038
Phone
(440) 879-1108
Fax
(440) 334-5403
NPI assigned
Feb 25, 2016
Last updated
Mar 9, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2016

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

Authorized official

Name
Rachel Petrick, NPNPI 1740418060
Title
Tax Id Owner
Phone
(440) 879-1108

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
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

16224 Pearl Rd
Strongsville, OH 44136-6038

Mailing address

18519 Martins LN
Strongsville, OH 44149-6864
Phone (440) 879-1108

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1456358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457481600000",
    "number": "1124488705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18519 MARTINS LN",
            "city": "STRONGSVILLE",
            "state": "OH",
            "postal_code": "441496864",
            "telephone_number": "440-879-1108",
            "fax_number": "440-334-5403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16224 PEARL RD",
            "city": "STRONGSVILLE",
            "state": "OH",
            "postal_code": "441366038",
            "telephone_number": "440-879-1108",
            "fax_number": "440-334-5403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYCARE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-25",
        "last_updated": "2016-03-09",
        "status": "A",
        "authorized_official_last_name": "PETRICK",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_title_or_position": "TAX ID OWNER",
        "authorized_official_telephone_number": "440-879-1108",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Strongsville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2016; 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.