NPIMap

Organization Active NPI

Northeast Ohio Neighborhood Health Services, Inc.

  • Primary Care Clinic/Center
  • Cleveland, OH
National Provider Identifier
1578055174
Registry record updated Feb 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
NORTHEAST OHIO NEIGHBORHOOD HEALTH SERVICES, INC.
Practice address
10505 Saint Clair Ave Ste 101
Cleveland, OH 44108-1973
Phone
(216) 325-6556
Fax
(216) 231-3828
NPI assigned
May 31, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2019

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

Authorized official

Name
Vicki Marie
Title
Provider Relations Manager
Phone
(216) 231-7700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

10505 Saint Clair Ave Ste 101
Cleveland, OH 44108-1973

Mailing address

4800 Payne Ave
Cleveland, OH 44103-2443
Phone (216) 231-7700

Other identifiers 1

IdentifierTypeStateIssuer
0333579MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190131002199 OH Part B Supplier - Clinic/Group Practice 5799756615 Receives reassigned benefits from 3 practitioners
Practice locations: Cleveland, OH

Other NPIs with the same Medicare PAC ID 12

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Northeast Ohio Neighbor14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1527724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550620800000",
    "number": "1578055174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 PAYNE AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441032443",
            "telephone_number": "216-231-7700",
            "fax_number": "216-231-3828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10505 SAINT CLAIR AVE STE 101",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441081973",
            "telephone_number": "216-325-6556",
            "fax_number": "216-231-3828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST OHIO NEIGHBORHOOD HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-31",
        "last_updated": "2019-02-20",
        "status": "A",
        "authorized_official_last_name": "MARIE",
        "authorized_official_first_name": "VICKI",
        "authorized_official_title_or_position": "PROVIDER RELATIONS MANAGER",
        "authorized_official_telephone_number": "216-231-7700"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0333579",
            "state": "OH"
        }
    ],
    "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 Feb 20, 2019; 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.