Individual provider Active NPI

Anthony Killion, PEERSUPPORT

  • Case Manager/Care Coordinator
  • Cleveland, OH
National Provider Identifier
1376266015
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
003511 Issued in OH
Practice address
17608 Euclid Ave
Cleveland, OH 44112-1216
Phone
(773) 829-5578
NPI assigned
Sep 19, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X 003511 OH Primary

Addresses

Primary practice location

17608 Euclid Ave
Cleveland, OH 44112-1216

Mailing address

17608 Euclid Ave
Cleveland, OH 44112-1216
Phone (773) 829-5578

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
003511OHMDCase Manager/Care Coordinator

Practice roles

OrganizationSpecialtyStatusNew patients
Alliant Treatment Center Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1663545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1376266015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17608 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441121216",
            "telephone_number": "773-829-5578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17608 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441121216",
            "telephone_number": "773-829-5578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLION",
        "first_name": "ANTHONY",
        "credential": "PEERSUPPORT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-19",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OH",
            "license": "003511",
            "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 19, 2022; 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.