Individual provider Active NPI

Beverly J Paige, MD

  • Surgery Physician
  • Lorain, OH
National Provider Identifier
1164498390
Registry record updated Jan 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
35051012P Issued in OH
Practice address
3600 Kolbe Rd
Ste 203
Lorain, OH 44053-1654
Phone
(440) 960-4522
Fax
(440) 960-4523
NPI assigned
Feb 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 35051012P OH Primary

Addresses

Primary practice location

3600 Kolbe Rd
Ste 203
Lorain, OH 44053-1654

Mailing address

PO Box 636643
Cincinnati, OH 45263-6643
Phone (440) 989-3801

Other identifiers 3

IdentifierTypeStateIssuer
3025372MedicaidOH
0236248MedicaidOH
0819912MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35051012POHMDSurgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420761600000",
    "number": "1164498390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636643",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636643",
            "telephone_number": "440-989-3801",
            "fax_number": "440-960-0264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 KOLBE RD",
            "address_2": "STE 203",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440531654",
            "telephone_number": "440-960-4522",
            "fax_number": "440-960-4523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAIGE",
        "first_name": "BEVERLY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-27",
        "last_updated": "2015-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "35051012P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3025372",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0236248",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0819912",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lorain, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2015; 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.