Individual provider Active NPI

Clifford Michael Sonnie, M.D., M.P.H.

  • Public Health & General Preventive Medicine Physician
  • Medina, OH
National Provider Identifier
1598865123
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X
License
049066 Issued in OH
Practice address
3985 Medina Rd
Suite 250
Medina, OH 44256-5968
Phone
(330) 764-4242
NPI assigned
Sep 24, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health & General Preventive Medicine Physician 2083P0901X 049066 OH Primary

Addresses

Primary practice location

3985 Medina Rd
Suite 250
Medina, OH 44256-5968

Mailing address

3985 Medina Rd
Suite 250
Medina, OH 44256-5968
Phone (330) 764-4242

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Dec 17, 2012 through Dec 17, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
049066OHMDPublic Health & General Preventive Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Backbone of Health LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598865123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3985 MEDINA RD",
            "address_2": "SUITE 250",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442565968",
            "telephone_number": "330-764-4242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3985 MEDINA RD",
            "address_2": "SUITE 250",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442565968",
            "telephone_number": "330-764-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONNIE",
        "first_name": "CLIFFORD",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "OH",
            "license": "049066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medina, OH

Sources for this page

Verify at the official NPI Registry.