Organization Active NPI

Euclid Pediatrics Inc

  • Pediatrics Physician
  • Mentor, OH
National Provider Identifier
1598841835
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35041455 Issued in OH
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

Updated by the provider on Aug 22, 2020

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)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
2066964MedicaidOH

National Provider Directory

National Provider Directory
Tax ID family
Euclid Pediatrics Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

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.

Verify at the official NPI Registry.