Active NPI
Vincent William Dennis, M.D.
- Nephrology Physician
- Chagrin Falls, OH
National Provider Identifier
1669620308
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 64056
- Practice address
- 5695 Park Wood Cir
Chagrin Falls, OH 44022-3529 - Phone
- (440) 349-1583
- NPI assigned
- Sep 7, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 64056 | OH | Primary |
| Nephrology Physician | 207RN0300X | 18629 | NC |
Addresses
Primary practice location
5695 Park Wood Cir
Chagrin Falls, OH 44022-3529
Mailing address
5695 Park Wood Cir
Chagrin Falls, OH 44022-3529
Phone (440) 349-1583
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0896071 | Medicaid | OH |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18629 | NC | MD | Nephrology Physician |
| 64056 | OH | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Lima Memorial Health System
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1220745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1220745600000",
"number": "1669620308",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5695 PARK WOOD CIR",
"city": "CHAGRIN FALLS",
"state": "OH",
"postal_code": "440223529",
"telephone_number": "440-349-1583"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5695 PARK WOOD CIR",
"city": "CHAGRIN FALLS",
"state": "OH",
"postal_code": "440223529",
"telephone_number": "440-349-1583"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DENNIS",
"first_name": "VINCENT",
"middle_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-09-07",
"last_updated": "2008-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "OH",
"license": "64056",
"primary": true
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "NC",
"license": "18629",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0896071",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chagrin Falls, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.