Individual provider Active NPI

Raphaelle Woods, NURSE PRACTITIONER

  • Gerontology Nurse Practitioner
  • Cleveland, OH
National Provider Identifier
1508228446
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN.CNP.0034025 Issued in OH
Practice address
15105 Saint Clair Ave
Cleveland, OH 44110-3719
Phone
(216) 800-8020
NPI assigned
Mar 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X APRN.CNP.0034025 OH Primary

Addresses

Primary practice location

15105 Saint Clair Ave
Cleveland, OH 44110-3719

Mailing address

15105 Saint Clair Ave
Cleveland, OH 44110-3719
Phone (216) 800-8020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230925000192 OH Practitioner - Nurse Practitioner 0648631754 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0034025OHMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dedicated Ohio Holding LLC CurrentSince Sep 1, 2025 Accepting new patients
Renaissance Behavioral Health LLC CurrentSince Jul 8, 2023 Accepting new patients
Dr Miodrag Zivic LLC CurrentSince Apr 1, 2024 Accepting new patients

Locations

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

7642 Reading Rd
Cincinnati, OH 45237
Phone (513) 208-2880

25200 Chagrin Blvd
Ste 300
Cleveland, OH 44122
Phone (216) 383-2834

3740 Euclid Ave
Ste 101
Cleveland, OH 44115
Phone (440) 453-0754

15105 Saint Clair Ave
Cleveland, OH 44110
Phone (216) 451-6260

99 Northline Cir
Ste 215
Euclid, OH 44119
Phone (216) 383-2834

Organizations & group practices 3

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": "1458518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1508228446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15105 SAINT CLAIR AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441103719",
            "telephone_number": "216-800-8020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15105 SAINT CLAIR AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441103719",
            "telephone_number": "216-800-8020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODS",
        "first_name": "RAPHAELLE",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-21",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OH",
            "license": "APRN.CNP.0034025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.