Organization Active NPI

Wingspan Care Group

  • Primary Care Clinic/Center
  • Cleveland, OH
National Provider Identifier
1669188108
Registry record updated Jan 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
WINGSPAN CARE GROUP
Practice address
3518 W 25TH St
Cleveland, OH 44109-1951
Phone
(216) 741-2241
NPI assigned
Jan 27, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2023

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

Authorized official

Name
Leigh Hall
Title
General Counsel
Phone
(216) 320-8222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

3518 W 25TH St
Cleveland, OH 44109-1951

Mailing address

22001 Fairmount Blvd
Shaker Heights, OH 44118-4819
Phone (216) 932-2800

Other identifiers 1

IdentifierTypeStateIssuer
0332211MedicaidOH

National Provider Directory

National Provider Directory
Tax ID family
Wingspan Care Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1674777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674777600000",
    "number": "1669188108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22001 FAIRMOUNT BLVD",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441184819",
            "telephone_number": "216-932-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3518 W 25TH ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441091951",
            "telephone_number": "216-741-2241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINGSPAN CARE GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-27",
        "last_updated": "2023-01-27",
        "certification_date": "2023-01-27",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "LEIGH",
        "authorized_official_title_or_position": "GENERAL COUNSEL",
        "authorized_official_telephone_number": "216-320-8222"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0332211",
            "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 Jan 27, 2023; 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.