Active NPI
Signature Health Medical Group, Inc
- Community Health Clinic/Center
- Willoughby, OH
National Provider Identifier
1205293164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Clinic/Center
- Legal business name
- SIGNATURE HEALTH MEDICAL GROUP, INC
- Practice address
- 38882 Mentor Ave
Willoughby, OH 44094-7875 - Phone
- (440) 953-9999
- Fax
- (440) 918-3839
- NPI assigned
- Jan 24, 2016
- 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
- Jonathan Albert Lee
- Title
- Ceo
- Phone
- (216) 402-6269
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Clinic/Center | 261QC1500X | Primary |
Addresses
Primary practice location
38882 Mentor Ave
Willoughby, OH 44094-7875
Mailing address
38882 Mentor Ave
Willoughby, OH 44094-7875
Phone (440) 953-9999
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1453593600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1453593600000",
"number": "1205293164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38882 MENTOR AVE",
"city": "WILLOUGHBY",
"state": "OH",
"postal_code": "440947875",
"telephone_number": "440-953-9999",
"fax_number": "440-918-3839"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "38882 MENTOR AVE",
"city": "WILLOUGHBY",
"state": "OH",
"postal_code": "440947875",
"telephone_number": "440-953-9999",
"fax_number": "440-918-3839"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SIGNATURE HEALTH MEDICAL GROUP, INC",
"organizational_subpart": "NO",
"enumeration_date": "2016-01-24",
"last_updated": "2016-01-24",
"status": "A",
"authorized_official_last_name": "LEE",
"authorized_official_first_name": "JONATHAN",
"authorized_official_middle_name": "ALBERT",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "216-402-6269"
},
"taxonomies": [
{
"code": "261QC1500X",
"taxonomy_group": "",
"desc": "Clinic/Center, Community Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Willoughby, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.