Individual provider Active NPI

Charles Richardson Cowap, M.D.

  • Emergency Medicine Physician
  • Lakewood, OH
National Provider Identifier
1265489926
Registry record updated May 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35081096C Issued in OH
Practice address
14519 Detroit Ave
Lakewood, OH 44107-4316
Phone
(216) 521-4200
NPI assigned
May 28, 2006
Last updated
May 7, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 35081096C OH Primary
Family Medicine Physician 207Q00000X 35081096 OH

Addresses

Primary practice location

14519 Detroit Ave
Lakewood, OH 44107-4316

Mailing address

16616 Aldersyde Dr
Shaker HTS, OH 44120-2514

Other identifiers 4

IdentifierTypeStateIssuer
2373239MedicaidOH
341542312098OtherOHCARESOURCE
000000380937OtherOHANTHEM BC/BS
378646OtherOHWELLCARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35081096OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mobile Hyperbaric Centers, LLC CurrentSince Apr 30, 2003 Accepting new patients
Lakewood Hospital Association Emergency Medicine Past Accepting new patients
Lakewood Hospital Association Past Accepting new patients

Locations

18697 Bagley Rd
Middleburg Heights, OH 44130
Phone (440) 816-8000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210118400000",
    "number": "1265489926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16616 ALDERSYDE DR",
            "city": "SHAKER HTS",
            "state": "OH",
            "postal_code": "441202514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14519 DETROIT AVE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441074316",
            "telephone_number": "216-521-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COWAP",
        "first_name": "CHARLES",
        "middle_name": "RICHARDSON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-28",
        "last_updated": "2008-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35081096C",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35081096",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2373239",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE",
            "identifier": "341542312098",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "000000380937",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "378646",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 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.

Verify at the official NPI Registry.