Active NPI
Euclid Pediatrics Inc
- Pediatrics Physician
- Mentor, OH
National Provider Identifier
1598841835
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 35041455
- Legal business name
- EUCLID PEDIATRICS INC
- Practice address
- 7200 Center St
Ste 200
Mentor, OH 44060-4900 - Phone
- (440) 255-0706
- Fax
- (440) 255-4451
- NPI assigned
- Oct 30, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Daniel G Fuller, MD
- Title
- Partner
- Phone
- (216) 261-2606
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 35041455 | OH | Primary |
Addresses
Primary practice location
7200 Center St
Ste 200
Mentor, OH 44060-4900
Mailing address
26250 Euclid Ave
Ste 611
Euclid, OH 44132-3305
Phone (216) 261-2606
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2066964 | Medicaid | OH |
National Provider Directory
National Provider Directory- Tax ID family
- Euclid Pediatrics Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Pediatrics Physician
- Euclid, OH
- NPI 1720176548
Locations
7200 Center St
Ste 200
Mentor, OH 44060
Phone (440) 255-0706
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162166400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1598841835",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26250 EUCLID AVE",
"address_2": "STE 611",
"city": "EUCLID",
"state": "OH",
"postal_code": "441323305",
"telephone_number": "216-261-2606",
"fax_number": "216-261-9814"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7200 CENTER ST",
"address_2": "STE 200",
"city": "MENTOR",
"state": "OH",
"postal_code": "440604900",
"telephone_number": "440-255-0706",
"fax_number": "440-255-4451"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EUCLID PEDIATRICS INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-30",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "FULLER",
"authorized_official_first_name": "DANIEL",
"authorized_official_middle_name": "G",
"authorized_official_title_or_position": "PARTNER",
"authorized_official_telephone_number": "216-261-2606",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pediatrics",
"state": "OH",
"license": "35041455",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2066964",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Mentor, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.