County of Lake Court House

Primary specialty

State or Local Public Health Clinic/CenterTaxonomy code 261QP0905X

Legal business name

COUNTY OF LAKE COURT HOUSE

Practice address

5966 Heisley Rd
Mentor, OH 44060-1886

Phone

(440) 350-2554

Fax

(440) 350-2956

NPI assigned

Dec 13, 2006

Last updated

Jan 22, 2019By 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

Mr. Ron Graham, RD/RDN, LD, MPH

Title

Health Comissioner

Phone

(440) 350-2554

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Lake County General Health District Other name

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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.

• Richard Don Clark, MD

  • Family Medicine Physician
  • Marietta, OH
  • NPI 1053316364
  NPD (past)

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548115200000",
    "number": "1598826216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5966 HEISLEY RD",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440601886",
            "telephone_number": "440-350-2554",
            "fax_number": "440-350-2956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5966 HEISLEY RD",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440601886",
            "telephone_number": "440-350-2554",
            "fax_number": "440-350-2956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF LAKE COURT HOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2019-01-22",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "RON",
        "authorized_official_title_or_position": "HEALTH COMISSIONER",
        "authorized_official_telephone_number": "440-350-2554",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RD/RDN, LD, MPH"
    },
    "taxonomies": [
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0567480",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake County General Health District",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lake County General Health District",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Barbara Corral, FNP
• Alyssa Corrigan
• Nadine R. Costantini, LISW
• Jodi Coughlin, RN
• Counseling Equals Growth LLC
• Victoria Couture, CNP
• Tihesha Cowthon-Melton
• Julia Cox
• Diane Coy
• Brittany Jean Coyne

• State or Local Public Health Clinic/Center in Mentor, OH
• Providers in Mentor, OH by specialty
• State or Local Public Health Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.