NPIMap

Organization Active NPI

Northeastern Ohio Neurosurgical Associates

  • Neurological Surgery Physician
  • Willoughby, OH
National Provider Identifier
1285762583
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
NORTHEASTERN OHIO NEUROSURGICAL ASSOCIATES
Practice address
2785 Som Center Rd
Willoughby, OH 44094-9139
Phone
(440) 975-5575
Fax
(440) 944-0920
NPI assigned
Mar 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Hollis A. Miker, MBA
Title
Practice Administrator
Phone
(440) 975-5575

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X Primary

Addresses

Primary practice location

2785 Som Center Rd
Willoughby, OH 44094-9139

Mailing address

2785 Som Center Rd
Willoughby, OH 44094-9139
Phone (440) 975-5575

Other identifiers 1

IdentifierTypeStateIssuer
2468351MedicaidOH

National Provider Directory

National Provider Directory

Locations

12000 McCracken Rd
Ste 465
Garfield Hts, OH 44125
Phone (440) 975-5575

6801 Mayfield Rd
Ste 540
Mayfield Heights, OH 44124
Phone (440) 461-8317

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285762583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2785 SOM CENTER RD",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440949139",
            "telephone_number": "440-975-5575",
            "fax_number": "440-944-0920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2785 SOM CENTER RD",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440949139",
            "telephone_number": "440-975-5575",
            "fax_number": "440-944-0920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEASTERN OHIO NEUROSURGICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MIKER",
        "authorized_official_first_name": "HOLLIS",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "440-975-5575",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2468351",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Willoughby, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.