University Primary Care Practices Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

UNIVERSITY PRIMARY CARE PRACTICES INC

Practice address

1611 S Green Rd Ste 260
South Euclid, OH 44121-4192

Phone

(216) 692-3500

Fax

(216) 692-3501

NPI assigned

May 25, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Steve Riddle

Title

Director of Billing Services

Phone

(216) 383-6480

Specialties & licenses 1

Addresses

Other names 1

• UHMP - GREEN RD MEDICAL GROUP Doing business as

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270684800000",
    "number": "1255542890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8792",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049158792",
            "telephone_number": "216-691-3500",
            "fax_number": "216-691-3501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 S GREEN RD STE 260",
            "city": "SOUTH EUCLID",
            "state": "OH",
            "postal_code": "441214192",
            "telephone_number": "216-692-3500",
            "fax_number": "216-692-3501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY PRIMARY CARE PRACTICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-25",
        "last_updated": "2010-04-08",
        "status": "A",
        "authorized_official_last_name": "RIDDLE",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "DIRECTOR OF BILLING SERVICES",
        "authorized_official_telephone_number": "216-383-6480",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UHMP - GREEN RD MEDICAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Internal Medicine Physician in South Euclid, OH
• Providers in South Euclid, OH by specialty
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.