Organization Active NPI

North Coast Gastroenterology, Inc

  • Specialist
  • Elyria, OH
National Provider Identifier
1689793655
Registry record updated Jul 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
NORTH COAST GASTROENTEROLOGY, INC
Practice address
125 E Broad St Ste 114
Elyria, OH 44035-6429
Phone
(440) 329-5943
NPI assigned
Mar 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2007

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

Authorized official

Name
James E Lisi, M.D.
Title
President
Phone
(440) 329-5943

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X OH Primary

Addresses

Primary practice location

125 E Broad St Ste 114
Elyria, OH 44035-6429

Mailing address

125 E Broad St Ste 114
Elyria, OH 44035-6429
Phone (440) 329-5943

Other identifiers 1

IdentifierTypeStateIssuer
0757972MedicaidOH

National Provider Directory

National Provider Directory

Locations

125 E Broad St
Ste 114
Elyria, OH 44035
Phone (440) 329-5943

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185494400000",
    "number": "1689793655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 E BROAD ST STE 114",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440356429",
            "telephone_number": "440-329-5943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 E BROAD ST STE 114",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440356429",
            "telephone_number": "440-329-5943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH COAST GASTROENTEROLOGY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-27",
        "status": "A",
        "authorized_official_last_name": "LISI",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "440-329-5943",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0757972",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elyria, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2007; 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.