NPIMap

Organization Active NPI

North Coast Professional Company, LLC

  • Urgent Care Clinic/Center
  • Vermilion, OH
National Provider Identifier
1487099321
Registry record updated May 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
NORTH COAST PROFESSIONAL COMPANY, LLC
Practice address
1605 State Rd
Vineyard Square Plaza #9
Vermilion, OH 44089-9141
Phone
(440) 967-1128
Fax
(440) 967-1172
NPI assigned
May 6, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2013

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

Authorized official

Name
Janis A Shriver, HCMBA, CPA
Title
Vice President
Phone
(419) 557-5540

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

1605 State Rd
Vineyard Square Plaza #9
Vermilion, OH 44089-9141

Mailing address

1031 Pierce St
Suite D
Sandusky, OH 44870-4669
Phone (419) 557-5541

Other identifiers 1

IdentifierTypeStateIssuer
2021707MedicaidOH

Other names 1

  • Firelands Physician Group Urgent Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Firelands Physician Group Urgent Care4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1367798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367798400000",
    "number": "1487099321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1031 PIERCE ST",
            "address_2": "SUITE D",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448704669",
            "telephone_number": "419-557-5541",
            "fax_number": "419-557-5542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 STATE RD",
            "address_2": "VINEYARD SQUARE PLAZA #9",
            "city": "VERMILION",
            "state": "OH",
            "postal_code": "440899141",
            "telephone_number": "440-967-1128",
            "fax_number": "440-967-1172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH COAST PROFESSIONAL COMPANY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-06",
        "last_updated": "2013-05-06",
        "status": "A",
        "authorized_official_last_name": "SHRIVER",
        "authorized_official_first_name": "JANIS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "419-557-5540",
        "authorized_official_credential": "HCMBA, CPA"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2021707",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Firelands Physician Group Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vermilion, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2013; 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.