Dana Chisholm

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

001043 Issued in OH

Practice address

16321 Lorain Ave Apt 112
Cleveland, OH 44111-5525

Phone

(216) 618-8545

NPI assigned

Aug 23, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1566518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1265089254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16321 LORAIN AVE APT 112",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441115525",
            "telephone_number": "216-618-8545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16321 LORAIN AVE APT 112",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441115525",
            "telephone_number": "216-618-8545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHISHOLM",
        "first_name": "DANA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-23",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Peer Specialist",
            "state": "OH",
            "license": "001043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chiro Cleveland LLC
• Chiropractic Wellness Center of Greater Cleveland
• Abby Gurtrude Chisholm, LPN
• Amani Chisholm
• Catherine Jordan Chisholm, PA-C
• Jason Timothy Chisholm, MD
• Jessica L Chisholm, MD
• Marcus Chisholm
• Anita Chitluri, O.D.
• Jorge Fernando Chiu Quevedo, M.D.

• Peer Specialist in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Peer Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2021; 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.