Active NPI
Outreach Professional Services Inc
Doing business as St Vincent Medical Group
- Durable Medical Equipment & Medical Supplies
- Independence, OH
National Provider Identifier
1184916033
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- Legal business name
- OUTREACH PROFESSIONAL SERVICES INC
- Doing business as
- St Vincent Medical Group
- Practice address
- 6701 Rockside Rd
Suite 100
Independence, OH 44131-2358 - Phone
- (216) 328-0418
- Fax
- (216) 328-0847
- NPI assigned
- May 11, 2011
- Last updated
- Oct 2, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kelly A Mowrer
- Title
- Credentialing Specialist
- Phone
- (216) 472-2741
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | Primary |
Addresses
Primary practice location
6701 Rockside Rd
Suite 100
Independence, OH 44131-2358
Mailing address
PO Box 932127
Cleveland, OH 44193-0008
Phone (216) 472-2730
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0251856 | Medicaid | OH |
Other names 1
- St Vincent Medical Group
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
dba St Vincent Charity Community Health Center
- Urgent Care Clinic/Center
- Cleveland, OH
- NPI 1871202481
Member Of
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1305072000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1412208000000",
"number": "1184916033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 932127",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441930008",
"telephone_number": "216-472-2730",
"fax_number": "216-472-2740"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6701 ROCKSIDE RD",
"address_2": "SUITE 100",
"city": "INDEPENDENCE",
"state": "OH",
"postal_code": "441312358",
"telephone_number": "216-328-0418",
"fax_number": "216-328-0847"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OUTREACH PROFESSIONAL SERVICES INC",
"organizational_subpart": "NO",
"enumeration_date": "2011-05-11",
"last_updated": "2014-10-02",
"status": "A",
"authorized_official_last_name": "MOWRER",
"authorized_official_first_name": "KELLY",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
"authorized_official_telephone_number": "216-472-2741"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0251856",
"state": "OH"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "St Vincent Medical Group",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Independence, OH
- Colby Lee Orr
- Shaun Michael Ortega, P.A.
- Annette Ortiz
- Corey J. Orzolek, CNP
- Lisa Kay Oswald, PT
- Outreach Professional Services Inc (St Vincent Medical Group)
- Outreach Professional Services, Inc (St Vincent Medical Group)
- Outreach Professional Services, Inc. (Cuyahoga Physician Network)
- Stacey Outridge, MOT, OTR/L
- Ravza Ozturk, M.ED., LPC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.