Individual provider Active NPI

Kizziah Howard

  • Case Manager/Care Coordinator
  • Cleveland, OH
National Provider Identifier
1497256952
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
11201 Shaker Blvd Ste 102
Cleveland, OH 44104-3833
Phone
(216) 758-4120
Fax
(216) 609-3461
NPI assigned
Feb 21, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

11201 Shaker Blvd Ste 102
Cleveland, OH 44104-3833

Mailing address

5439 Burkhardt Rd
Dayton, OH 45431-2111
Phone (740) 918-9616

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

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Group Home, LLC Community/Behavioral Health CurrentSince Oct 8, 2025 Accepting new patients
Phoenix Group Home, LLC Community/Behavioral Health PastSince Apr 30, 2023 Accepting new patients

Locations

11201 Shaker Blvd
Ste 102
Cleveland, OH 44104
Phone (216) 721-6900

5439 Burkhardt Rd
Riverside, OH 45431
Phone (740) 918-9616

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/pathihc/r4/

Organizations & group practices 2

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": "1519171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682553600000",
    "number": "1497256952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5439 BURKHARDT RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454312111",
            "telephone_number": "740-918-9616",
            "fax_number": "216-609-3461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11201 SHAKER BLVD STE 102",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441043833",
            "telephone_number": "216-758-4120",
            "fax_number": "216-609-3461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOWARD",
        "first_name": "KIZZIAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-21",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "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 Apr 27, 2023; 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.