Organization Active NPI

Primecare Practitioners LLC

  • Skilled Nursing Facility
  • Cleveland, OH
National Provider Identifier
1508685637
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
PRIMECARE PRACTITIONERS LLC
Practice address
5800 Fleet Ave Ste 2
Cleveland, OH 44105-3404
Phone
(440) 228-8302
Fax
(440) 484-5535
NPI assigned
Oct 7, 2024
Last updated
Dec 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Authorized official

Name
Julie Dobriansky, NPNPI 1437737830
Title
Nurse Practitioner
Phone
(440) 228-8302

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X NU
Skilled Nursing Facility 314000000X NU Primary
Long Term Care Hospital 282E00000X NU

Addresses

Primary practice location

5800 Fleet Ave Ste 2
Cleveland, OH 44105-3404

Mailing address

5800 Fleet Ave Ste 2
Cleveland, OH 44105-3404
Phone (440) 228-8302

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241231002179 OH Part B Supplier - Clinic/Group Practice 7012444177 Receives reassigned benefits from 2 practitioners
Practice locations: Cleveland, OH

National Provider Directory

National Provider Directory

Locations

5800 Fleet Ave
Ste 2
Cleveland, OH 44105
Phone (440) 228-8302

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1728259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734393600000",
    "number": "1508685637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 FLEET AVE STE 2",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441053404",
            "telephone_number": "440-228-8302",
            "fax_number": "440-484-5535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 FLEET AVE STE 2",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441053404",
            "telephone_number": "440-228-8302",
            "fax_number": "440-484-5535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMECARE PRACTITIONERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-07",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A",
        "authorized_official_last_name": "DOBRIANSKY",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "440-228-8302",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "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 Dec 17, 2024; 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.