Cleveland Childrens Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

CLEVELAND CHILDRENS SURGERY CENTER LLC

Practice address

7690 First PL Ste E
Bedford, OH 44146-6725

Phone

(216) 539-8253

Fax

(216) 302-3416

NPI assigned

Jan 7, 2019

Last updated

Feb 4, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Raymond Figueroa

Title

Ceo

Phone

(717) 759-4375

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1356814958. Details of each certification follow.

• CCN 36C0001328 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 36C0001328

Legal name

CLEVELAND CHILDREN'S SURGERY CENTER LLC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Aug 25, 2020

Last certification

Aug 25, 2020

Ownership / control type

Proprietary

Facility address

7690 First Place BLDG D Suite E
Oakwood Village, OH 44146

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

{
    "created_epoch": "1546819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549238400000",
    "number": "1356814958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "182 INDUSTRIAL RD",
            "city": "GLEN ROCK",
            "state": "PA",
            "postal_code": "173278626",
            "telephone_number": "717-759-4375",
            "fax_number": "717-759-4336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7690 FIRST PL STE E",
            "city": "BEDFORD",
            "state": "OH",
            "postal_code": "441466725",
            "telephone_number": "216-539-8253",
            "fax_number": "216-302-3416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEVELAND CHILDRENS SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-07",
        "last_updated": "2019-02-04",
        "status": "A",
        "authorized_official_last_name": "FIGUEROA",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "717-759-4375"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jonathan R Cobb, CT
• Ebony D Cole, L.P.N
• Kyley L Cole, LPN
• Nichelle Diane Coleman-Laster, M.D.

• Ambulatory Surgical Clinic/Center in Bedford, OH
• Providers in Bedford, OH by specialty
• Ambulatory Surgical Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.