Individual provider Active NPI

Riya Shanavas

  • Student in an Organized Health Care Education/Training Program
  • Lakewood, OH
National Provider Identifier
1295585222
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
14601 Detroit Ave
Lakewood, OH 44107-4205
Phone
(216) 237-5500
NPI assigned
Mar 25, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

14601 Detroit Ave
Lakewood, OH 44107-4205

Mailing address

14601 Detroit Ave
Lakewood, OH 44107-4205
Phone (216) 237-5500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240621002126 OH Order and Referring Only - Family PracticePractitioner - Family Practice 8628511359

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1711324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1295585222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14601 DETROIT AVE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441074205",
            "telephone_number": "216-237-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14601 DETROIT AVE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441074205",
            "telephone_number": "216-237-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANAVAS",
        "first_name": "RIYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-25",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, OH

Sources for this page

Verify at the official NPI Registry.