Individual provider Active NPI

Christine Ann Dearth, CNP

  • Nurse Practitioner
  • Lakewood, OH
National Provider Identifier
1164680435
Registry record updated Mar 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
367211 Issued in OH
Practice address
14601 Detroit Ave
Suite 540
Lakewood, OH 44107-4214
Phone
(216) 529-5300
Fax
(216) 529-5301
NPI assigned
May 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 367211 OH Primary

Addresses

Primary practice location

14601 Detroit Ave
Suite 540
Lakewood, OH 44107-4214

Mailing address

14601 Detroit Ave
Suite 540
Lakewood, OH 44107
Phone (216) 529-5300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150914002971 OH Practitioner - Nurse Practitioner 1456668011 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

2550 Som Ctr Rd
Willoughby Hills, OH 44094-9655
Phone (440) 943-2500

8950 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-8950

9500 Euclid Ave
Cleveland, OH 44195-0001

Hospital & facility affiliations

  • Cleveland Clinic Hospital, Cleveland, OH, CCN 360180
  • Hillcrest Hospital Hospital, Mayfield Heights, OH, CCN 360230
  • Ashtabula County Medical Center Hospital, Ashtabula, OH, CCN 360125

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
367211OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation CurrentSince Jul 29, 2015 Accepting new patients

Locations

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

14601 Detroit Ave
Ste 540
Lakewood, OH 44107
Phone (216) 228-2100

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1211500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457049600000",
    "number": "1164680435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14601 DETROIT AVE",
            "address_2": "SUITE 540",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "44107",
            "telephone_number": "216-529-5300",
            "fax_number": "216-529-5301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14601 DETROIT AVE",
            "address_2": "SUITE 540",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441074214",
            "telephone_number": "216-529-5300",
            "fax_number": "216-529-5301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEARTH",
        "first_name": "CHRISTINE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-23",
        "last_updated": "2016-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "367211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, OH

Sources for this page

Verify at the official NPI Registry.