Individual provider Active NPI

Judith Chassis Gerblich, MD

  • Ophthalmology Physician
  • Cleveland, OH
National Provider Identifier
1275623944
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
35041172 Issued in OH
Practice address
1422 Euclid Ave
616
Cleveland, OH 44115-1902
Phone
(216) 771-6565
Fax
(216) 921-8891
NPI assigned
Oct 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 35041172 OH Primary

Addresses

Primary practice location

1422 Euclid Ave
616
Cleveland, OH 44115-1902

Mailing address

PO Box 201987
Cleveland, OH 44120-8116
Phone (440) 717-1113

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35041172OHMDOphthalmology Physician

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275623944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 201987",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441208116",
            "telephone_number": "440-717-1113",
            "fax_number": "216-921-8891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1422 EUCLID AVE",
            "address_2": "616",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441151902",
            "telephone_number": "216-771-6565",
            "fax_number": "216-921-8891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERBLICH",
        "first_name": "JUDITH",
        "middle_name": "CHASSIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OH",
            "license": "35041172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.