NPIMap

Organization Active NPI

Wissam Khoury DPM LLC

  • Podiatrist
  • Cleveland, OH
National Provider Identifier
1295064343
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
36003289 Issued in OH
Legal business name
WISSAM KHOURY DPM LLC
Practice address
2475 E 22ND St Ste 120
Cleveland, OH 44115-3221
Phone
(216) 367-9444
NPI assigned
Dec 21, 2009
Last updated
Sep 8, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2026

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

Authorized official

Name
Wissam Khoury, DPMNPI 1104886910
Title
Owner
Phone
(216) 921-3668

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X 36003289 OH Primary

Addresses

Primary practice location

2475 E 22ND St Ste 120
Cleveland, OH 44115-3221

Mailing address

2475 E 22ND St Ste 120
Cleveland, OH 44115-3221
Phone (216) 367-9444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100310000565 OH Part B Supplier - Clinic/Group Practice 2668517061 Receives reassigned benefits from 15 practitioners
Practice locations: Cleveland, OH

National Provider Directory

National Provider Directory

Locations

3487 Center Rd
Ste 4
Brunswick, OH 44212
Phone (330) 225-7520

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1261353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788825600000",
    "number": "1295064343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2475 E 22ND ST STE 120",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441153221",
            "telephone_number": "216-367-9444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2475 E 22ND ST STE 120",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441153221",
            "telephone_number": "216-367-9444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISSAM KHOURY DPM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-21",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A",
        "authorized_official_last_name": "KHOURY",
        "authorized_official_first_name": "WISSAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "216-921-3668",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36003289",
            "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 Sep 8, 2026; 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.