Active NPI
North Shore Podiatry Inc
- Podiatrist
- Avon Lake, OH
National Provider Identifier
1245357771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 36003128
- Legal business name
- NORTH SHORE PODIATRY INC
- Practice address
- 515 Moore Rd
Suite 3
Avon Lake, OH 44012-2366 - Phone
- (440) 930-8637
- NPI assigned
- Mar 22, 2007
- 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
- Paul Shearer, DPM
- Title
- Podiatrist Owner
- Phone
- (440) 930-8637
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 36003128 | OH | Primary |
Addresses
Primary practice location
515 Moore Rd
Suite 3
Avon Lake, OH 44012-2366
Mailing address
515 Moore Rd
Suite 3
Avon Lake, OH 44012-2366
Phone (440) 930-8637
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2278306 | Medicaid | OH | |
| 2853309 | Medicaid | OH | |
| DD8373 | Other | OH | RAILROAD MEDICARE |
National Provider Directory
National Provider DirectoryLocations
515 Moore Rd
Ste 3
Avon Lake, OH 44012
Phone (440) 930-8637
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Podiatrist
- Fargo, ND
- NPI 1518960301
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174521600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1226448000000",
"number": "1245357771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "515 MOORE RD",
"address_2": "SUITE 3",
"city": "AVON LAKE",
"state": "OH",
"postal_code": "440122366",
"telephone_number": "440-930-8637"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 MOORE RD",
"address_2": "SUITE 3",
"city": "AVON LAKE",
"state": "OH",
"postal_code": "440122366",
"telephone_number": "440-930-8637"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTH SHORE PODIATRY INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-22",
"last_updated": "2008-11-12",
"status": "A",
"authorized_official_last_name": "SHEARER",
"authorized_official_first_name": "PAUL",
"authorized_official_title_or_position": "PODIATRIST OWNER",
"authorized_official_telephone_number": "440-930-8637",
"authorized_official_credential": "DPM"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Podiatrist",
"state": "OH",
"license": "36003128",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2278306",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2853309",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "DD8373",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Avon Lake, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.