Individual provider Active NPI

Chauncey Blair

  • Case Manager/Care Coordinator
  • Cleveland, OH
National Provider Identifier
1568059301
Registry record updated Dec 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
12305 Arlington Ave
Cleveland, OH 44108-2359
Phone
(216) 451-5020
NPI assigned
Dec 28, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

12305 Arlington Ave
Cleveland, OH 44108-2359

Mailing address

1507 Saint Clair Ave NE
Cleveland, OH 44114-2003
Phone (202) 316-9910

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
First and Twenty Five LLC CurrentSince Jan 3, 2021 Accepting new patients

Locations

1507 Saint Clair Ave NE
Cleveland, OH 44114
Phone (216) 417-0047

12305 Arlington Ave
Cleveland, OH 44108
Phone (216) 451-5020

Organizations & group practices 1

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": "1609113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609113600000",
    "number": "1568059301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 SAINT CLAIR AVE NE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441142003",
            "telephone_number": "202-316-9910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12305 ARLINGTON AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441082359",
            "telephone_number": "216-451-5020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAIR",
        "first_name": "CHAUNCEY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-28",
        "last_updated": "2020-12-28",
        "certification_date": "2020-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "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 Dec 28, 2020; 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.