NPIMap

Organization Active NPI

Northeast Ohio Neighborhood Health Services, Inc.

  • Primary Care Clinic/Center
  • Cleveland, OH
National Provider Identifier
1376650952
Registry record updated Nov 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
NORTHEAST OHIO NEIGHBORHOOD HEALTH SERVICES, INC.
Practice address
1468 E 55TH St
Cleveland, OH 44103-1307
Phone
(216) 881-2000
Fax
(216) 812-8124
NPI assigned
Aug 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2018

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

Authorized official

Name
Mr. Willie F. Austin
Title
President & Ceo
Phone
(216) 231-7700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

1468 E 55TH St
Cleveland, OH 44103-1307

Mailing address

1468 E 55TH St
Cleveland, OH 44103-1307
Phone (216) 881-2000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190103000787 OH Part B Supplier - Clinic/Group Practice 5799756615 Receives reassigned benefits from 3 practitioners
Practice locations: Cleveland, OH

Other NPIs with the same Medicare PAC ID 12

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Northeast Ohio Neighbor14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Locations

1468 E 55th St
Cleveland, OH 44103
Phone (216) 541-5600

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541894400000",
    "number": "1376650952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1468 E 55TH ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441031307",
            "telephone_number": "216-881-2000",
            "fax_number": "216-812-8124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1468 E 55TH ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441031307",
            "telephone_number": "216-881-2000",
            "fax_number": "216-812-8124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST OHIO NEIGHBORHOOD HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-23",
        "last_updated": "2018-11-11",
        "status": "A",
        "authorized_official_last_name": "AUSTIN",
        "authorized_official_first_name": "WILLIE",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "216-231-7700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "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 Nov 11, 2018; 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.