NPIMap

Organization Active NPI

Northeast Surgical Wound Care, Inc.

  • Surgery Physician
  • Independence, OH
National Provider Identifier
1649215583
Registry record updated Jan 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
NORTHEAST SURGICAL WOUND CARE, INC.
Practice address
6100 Rockside Woods Blvd
Suite 425
Independence, OH 44131-2366
Phone
(216) 643-2780
Fax
(216) 524-0111
NPI assigned
Jun 17, 2006
Last updated
Jan 31, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2014

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

Authorized official

Name
Theresa Avsec
Title
Practice Manager
Phone
(216) 643-2780

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

6100 Rockside Woods Blvd
Suite 425
Independence, OH 44131-2366

Mailing address

6100 Rockside Woods Blvd
Suite 425
Independence, OH 44131-2366
Phone (216) 643-2780

Other identifiers 1

IdentifierTypeStateIssuer
2119380MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040520001174 OH Part B Supplier - Clinic/Group Practice 7416948153 Receives reassigned benefits from 40 practitioners

National Provider Directory

National Provider Directory

Locations (25 of 26)

73841 Pleasant Grove Rd
#1
Adena, OH 43901
Phone (740) 546-3013

974 E Market St
Akron, OH 44305
Phone (330) 762-9066

370 Tarlton Rd
Circleville, OH 43113
Phone (614) 592-0240

1801 Riverside Dr
Columbus, OH 43212
Phone (614) 486-9511

55 Lazelle Rd
Columbus, OH 43235
Phone (614) 885-3300

5600 Karl Rd
Columbus, OH 43229
Phone (614) 846-5420

601 Infirmary Rd
Dayton, OH 45417
Phone (937) 268-0161

1720 N Cross St
Dover, OH 44622
Phone (330) 364-8849

860 E Iron Ave
#1
Dover, OH 44622
Phone (330) 343-5568

12000 McCracken Rd
Ste 214
Garfield Hts, OH 44125
Phone (216) 587-3422

6100 Rockside Woods Blvd N
Independence, OH 44131
Phone 2166432780112

13330 Detroit Ave
Lakewood, OH 44107
Phone (216) 228-9500

195 Executive Dr
Marion, OH 43302
Phone (740) 387-9545

105 Majora Ln
Millersburg, OH 44654
Phone (330) 674-4444

6180 State Route 83
Millersburg, OH 44654
Phone (330) 674-0015

10608 Navarre Rd SW
Navarre, OH 44662
Phone (330) 767-3455

23225 Lorain Rd
North Olmsted, OH 44070
Phone (440) 779-6900

27500 Mill Rd
North Olmsted, OH 44070
Phone (216) 663-1203

3953 Navarre Ave
Oregon, OH 43616
Phone (419) 698-4521

5520 Broadview Rd
Parma, OH 44134
Phone (216) 749-4010

2511 Bentley Dr
#1
Salem, OH 44460
Phone (330) 337-9503

3416 Columbus Ave
Sandusky, OH 44870
Phone (419) 625-2454

4045 Indian Rd
Toledo, OH 43606
Phone (419) 536-3535

3500 Shiloh Springs Rd
Trotwood, OH 45426
Phone (937) 573-7452

400 S Melvin Eley Ave
Union City, OH 45390
Phone (614) 218-0580

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Gillette Nursing HomeWarren, OH, CCN 366129 Skilled nursing facility Adp of the SNF Jan 1, 2020

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 49

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 49

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391126400000",
    "number": "1649215583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 ROCKSIDE WOODS BLVD",
            "address_2": "SUITE 425",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441312366",
            "telephone_number": "216-643-2780",
            "fax_number": "216-524-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 ROCKSIDE WOODS BLVD",
            "address_2": "SUITE 425",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441312366",
            "telephone_number": "216-643-2780",
            "fax_number": "216-524-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST SURGICAL WOUND CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-17",
        "last_updated": "2014-01-31",
        "status": "A",
        "authorized_official_last_name": "AVSEC",
        "authorized_official_first_name": "THERESA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "216-643-2780"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2119380",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, OH

Sources for this page

Verify at the official NPI Registry.