Greater Cleveland Pediatrics

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

GREATER CLEVELAND PEDIATRICS

Practice address

3311 Richmond Rd
Beachwood, OH 44122-4195

Phone

(614) 562-3772

NPI assigned

Aug 31, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Keili Mistovich, MDNPI 1760748651

Title

Co-Owner

Phone

(614) 562-3772

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Keili Ann Mistovich, MD

  • Student in an Organized Health Care Education/Training Program
  • South Euclid, OH
  • NPI 1760748651
  NPD Authorized official

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

{
    "created_epoch": "1598832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598832000000",
    "number": "1184237968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2956 WASHINGTON BLVD",
            "city": "CLEVELAND HEIGHTS",
            "state": "OH",
            "postal_code": "441182450",
            "telephone_number": "614-562-3772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3311 RICHMOND RD",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441224195",
            "telephone_number": "614-562-3772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER CLEVELAND PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-31",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A",
        "authorized_official_last_name": "MISTOVICH",
        "authorized_official_first_name": "KEILI",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "614-562-3772",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rasheda Gray
• Great Lakes Care Inc
• Great Lakes Physical Medicine LLC
• Greater Cleveland Home Health Care Inc
• Greater Cleveland Optometry LLC
• Green Road Behavioral Health, Inc.
• Joann L Green, MSW
• Lisa Beth Green, PHD
• Heather Greene, M.ED, PCC, CECC
• James A Greenwood

• Pediatrics Physician in Beachwood, OH
• Providers in Beachwood, OH by specialty
• Pediatrics Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2020; 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.