Active NPI
Candice Hairston
- Rehabilitation Clinic/Center
- Cleveland, OH
National Provider Identifier
1639891252
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Clinic/Center
- Practice address
- 5408 Orey Ave
Cleveland, OH 44105-3339 - Phone
- (216) 240-4690
- NPI assigned
- Sep 12, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Clinic/Center | 261QR0400X | Primary |
Addresses
Primary practice location
5408 Orey Ave
Cleveland, OH 44105-3339
Mailing address
3831 Lee Heights Blvd
Cleveland, OH 44128-1635
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 86-3010133 | Other | OH | STATE OF OHIO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662940800000",
"number": "1639891252",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3831 LEE HEIGHTS BLVD",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441281635"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5408 OREY AVE",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441053339",
"telephone_number": "216-240-4690"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAIRSTON",
"first_name": "CANDICE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-09-12",
"last_updated": "2022-09-12",
"certification_date": "2022-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "261QR0400X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rehabilitation",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF OHIO",
"identifier": "86-3010133",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.