NPIMap

Organization Active NPI

Kaiser Permanente

Doing business as Ohio Permanente Medical Group

  • Clinical Medical Laboratory
  • Brooklyn HTS, OH
National Provider Identifier
1548363757
Registry record updated Jan 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
KAISER PERMANENTE
Doing business as
Ohio Permanente Medical Group
Practice address
5410 Lancaster Dr
Brooklyn HTS, OH 44131
Phone
(216) 265-8810
Fax
(216) 265-8890
NPI assigned
Sep 6, 2006
Last updated
Jan 16, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2008

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

Authorized official

Name
Tom Revis
Title
VP Cfo
Phone
(216) 265-8844

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

5410 Lancaster Dr
Brooklyn HTS, OH 44131

Mailing address

12301 Snow Road
Parma, OH 44130
Phone (216) 265-8810

Other identifiers 1

IdentifierTypeStateIssuer
0211372MedicaidOH

Other names 1

  • Ohio Permanente Medical Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kaiser Permanente16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200441600000",
    "number": "1548363757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12301 SNOW ROAD",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "44130",
            "telephone_number": "216-265-8810",
            "fax_number": "216-265-8890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5410 LANCASTER DR",
            "city": "BROOKLYN HTS",
            "state": "OH",
            "postal_code": "44131",
            "telephone_number": "216-265-8810",
            "fax_number": "216-265-8890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER PERMANENTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-06",
        "last_updated": "2008-01-16",
        "status": "A",
        "authorized_official_last_name": "REVIS",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "VP CFO",
        "authorized_official_telephone_number": "216-265-8844"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0211372",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ohio Permanente Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brooklyn HTS, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2008; 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.