Geauga Medical Therapy Center LLC

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

Legal business name

GEAUGA MEDICAL THERAPY CENTER LLC

Practice address

13170 Ravenna Rd
Suite 108
Chardon, OH 44024-7025

Phone

(440) 409-7055

Fax

(440) 279-4009

NPI assigned

Sep 5, 2015

Organization subpart

Yes

Parent organization

FADUL HEALTH PARTNERS, PLLCAs reported in NPPES

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

Authorized official

Name

Dr. Zaid Fadul, MD

Title

Ceo

Phone

(855) 360-4673

Specialties & licenses 3

Addresses

Part of

Fadul Health Partners PLLC

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Fadul Health Partners, PLLC

  • Addiction Medicine (Family Medicine) Physician
  • Chardon, OH
  • NPI 1154782761
  NPPES parent name

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

{
    "created_epoch": "1441411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468281600000",
    "number": "1376911495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 W MCDOWELL RD",
            "address_2": "SUITE A",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850031223",
            "telephone_number": "855-360-4673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13170 RAVENNA RD",
            "address_2": "SUITE 108",
            "city": "CHARDON",
            "state": "OH",
            "postal_code": "440247025",
            "telephone_number": "440-409-7055",
            "fax_number": "440-279-4009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEAUGA MEDICAL THERAPY CENTER LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FADUL HEALTH PARTNERS, PLLC",
        "enumeration_date": "2015-09-05",
        "last_updated": "2016-07-12",
        "status": "A",
        "authorized_official_last_name": "FADUL",
        "authorized_official_first_name": "ZAID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "855-360-4673",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "OH",
            "license": "35.122879",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Geauga Anesthesia Inc
• Geauga County Educational Service Center
• Geauga County Health District
• Geauga County Sheriffs Office
• Geauga Family Physicians, Inc
• Geauga Rehabilitation Engineering, Inc.
• Geauga Sleep Center
• Geauga Sports Medicine, LLC
• Geauga Surgical Associates Inc
• Katherine E Gehlfuss, LPC,CDCA

• All providers in Chardon, OH
• Addiction Medicine (Family Medicine) Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2016; 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.