Cleveland Center for Joint Reconstruction, Inc

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

CLEVELAND CENTER FOR JOINT RECONSTRUCTION, INC

Practice address

1730 W 25TH St
Cleveland, OH 44113-3108

Phone

(216) 363-2096

NPI assigned

Nov 26, 2007

Last updated

May 21, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Bernard Stulberg, MD

Title

Authorized Representative

Phone

(216) 363-2096

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1196035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211328000000",
    "number": "1578744116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6896 W SNOWVILLE RD",
            "city": "BRECKSVILLE",
            "state": "OH",
            "postal_code": "441413214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 W 25TH ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441133108",
            "telephone_number": "216-363-2096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEVELAND CENTER FOR JOINT RECONSTRUCTION, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-26",
        "last_updated": "2008-05-21",
        "status": "A",
        "authorized_official_last_name": "STULBERG",
        "authorized_official_first_name": "BERNARD",
        "authorized_official_title_or_position": "AUTHORIZED REPRESENTATIVE",
        "authorized_official_telephone_number": "216-363-2096",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0870884",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF LABOR",
            "identifier": "128086800",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER PERMANENTE",
            "identifier": "105758",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Cleveland Christian Home
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• Orthopaedic Surgery Physician in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Orthopaedic Surgery Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.