Healthsource of North Olmsted

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

License

2874 Issued in OH

Legal business name

HEALTHSOURCE OF NORTH OLMSTED

Practice address

24060 Lorain Rd
North Olmsted, OH 44070-2234

Phone

(440) 779-4226

NPI assigned

Aug 6, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Rich Sheppard

Title

Owner

Phone

(440) 779-4226

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186358400000",
    "number": "1346431269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24060 LORAIN RD",
            "city": "NORTH OLMSTED",
            "state": "OH",
            "postal_code": "440702234",
            "telephone_number": "440-779-4226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24060 LORAIN RD",
            "city": "NORTH OLMSTED",
            "state": "OH",
            "postal_code": "440702234",
            "telephone_number": "440-779-4226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSOURCE OF NORTH OLMSTED",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-06",
        "last_updated": "2007-08-06",
        "status": "A",
        "authorized_official_last_name": "SHEPPARD",
        "authorized_official_first_name": "RICH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "440-779-4226",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "OH",
            "license": "2874",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2242228",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Multi-Specialty Clinic/Center in North Olmsted, OH
• Providers in North Olmsted, OH by specialty
• Multi-Specialty Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.