Kristine Alice Herrmann Pelagalli, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

35074513 Issued in OH

Practice address

303 E Royalton Rd Ste 204
Broadview HTS, OH 44147-4034

Phone

(440) 717-2000

Fax

(440) 717-2001

NPI assigned

Jun 30, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588118400000",
    "number": "1659378131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 E ROYALTON RD STE 204",
            "city": "BROADVIEW HTS",
            "state": "OH",
            "postal_code": "441474034",
            "telephone_number": "440-717-2000",
            "fax_number": "440-717-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 E ROYALTON RD STE 204",
            "city": "BROADVIEW HTS",
            "state": "OH",
            "postal_code": "441474034",
            "telephone_number": "440-717-2000",
            "fax_number": "440-717-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRMANN PELAGALLI",
        "first_name": "KRISTINE",
        "middle_name": "ALICE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-30",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OH",
            "license": "35074513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David A Harding, D.P.M.
• Healthsource of Broadview Heights
• Andreana Marella Hendrickson, SLP
• Janice Lynn Hensley
• Shannon Hensley, COTA/L
• Dawn Hilt, LPTA
• Howard Waxman
• David Huang
• Imagining the Garden LLC (Season's Practice)
• J. Donald Moorhead, DDS Inc.

• Specialist in Broadview HTS, OH
• Providers in Broadview HTS, OH by specialty
• Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.