Active NPI
Beverly J Paige, MD
- Surgery Physician
- Lorain, OH
National Provider Identifier
1164498390
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 35051012P
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3025372 | Medicaid | OH | |
| 0236248 | Medicaid | OH | |
| 0819912 | Medicaid | OH |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 35051012P | OH | MD | Surgery 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.