Ohioguidestone
Organization Active NPI Developmental - Behavioral Pediatrics Physician · Berea, OH
NPI 1609123728 · NPPES record last updated Nov 20, 2017
Key facts
- NPI
- 1609123728
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Developmental - Behavioral Pediatrics Physician 2080P0006X
- Legal business name
- OHIOGUIDESTONE
- Practice address
- 202 E Bagley Rd
Berea, OH 44017-2058 - Phone
- (440) 260-8379
- NPI assigned
- Aug 8, 2012
- Organization subpart
- No
Authorized official
- Name
- Mandy Jackson
- Title
- Billing Supervisor
- Phone
- (440) 260-8328
Other NPIs on the same Medicare enrollment 3
Corporate family (same tax ID) 19
Member organizations 1
Practitioners 224
-
Dionna Lynn Adie, MSSA, LISW
-
Lauren Baker, CT MA
-
Emily S Becker, PC, MFT
-
Ronald Boudouris, LISW
-
Stephanie Campbell, LPCC
-
Melinda S Compton, LPC LICDC QMHS
-
Leah M Conner, LPCC
-
Regina D Coon, LISW
-
Jeyun Drake, LISW
-
Christine D Ellis, M.D.
-
Diane G Fouts, MSN,FNPC
-
Elizabeth Fulkroad, LISW
-
Ashley Fuller, LPCCS
-
Crystal A. Gerhardt, CNP
-
Patricia G Hardy, LISW-S
-
Miabrit Larson, LPC
-
Jonathon A Leigh, LSW
-
Megan L Loesch, LPCC LICDC
-
Lydia Mahler, LPC
-
Sherry Gaffin McDonald, LISW-S
-
Trisha McRae, LSW
-
Noah L Miller, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130308000507 | OH | Part B Supplier - Clinic/Group Practice | 5597910935 |
Receives reassigned benefits from 208 practitioners 3 other NPIs on this enrollment Practice locations: New Philadelphia, OH; Lancaster, OH; Napoleon, OH; Medina, OH; Marion, OH; Lorain, OH; Bryan, OH; Oberlin, OH… |
National Provider Directory
- Tax ID family
- Guidestone
Locations
1832 Adams St
Toledo, OH 43604
Phone (419) 720-9247
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental - Behavioral Pediatrics Physician |
2080P0006X | Yes |
Addresses
Primary practice location
202 E Bagley Rd
Berea, OH 44017-2058
Mailing address
434 Eastland Road
Berea, OH 44017-2058
Phone (440) 260-8327
Other names
- Guidestone
Other providers in Berea, OH
- Ohioguidestone
- Ohioguidestone
- Ohioguidestone
- Ohioguidestone
- Ohioguidestone
- Ohioguidestone
- Kimberly Olson
- Monica N Orange
- Rebekah Orellana
- Brittany B Paige
All providers in Berea, OH · Developmental - Behavioral Pediatrics Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 20, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.