NPIMap

Organization Active NPI

Cleveland Kidney & Hypertension Consultants Inc

  • Nephrology Physician
  • Euclid, OH
National Provider Identifier
1700074770
Registry record updated Aug 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
CLEVELAND KIDNEY & HYPERTENSION CONSULTANTS INC
Doing business as
CKHC Inc
Practice address
25301 Euclid Ave
Euclid, OH 44117-2609
Phone
(216) 261-6263
Fax
(216) 262-4964
NPI assigned
Oct 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2010

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

Authorized official

Name
Jan Dickard
Title
Billing Clerk
Phone
(216) 261-6263

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

25301 Euclid Ave
Euclid, OH 44117-2609

Mailing address

25301 Euclid Ave
Euclid, OH 44117-2609
Phone (216) 261-6263

Other identifiers 1

IdentifierTypeStateIssuer
2784876MedicaidOH

Other names 1

  • CKHC Inc Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050404000306 OH Part B Supplier - Clinic/Group Practice 0840247763 Receives reassigned benefits from 14 practitioners
Practice locations: Chardon, OH; Euclid, OH; Mayfield Heights, OH

National Provider Directory

National Provider Directory

Locations

13170 Ravenna Rd
Ste 118
Chardon, OH 44024
Phone (440) 285-7874

13170 Ravenna Rd
Chardon, OH 44024
Phone (440) 285-0828

25301 Euclid Ave
Fl Second
Euclid, OH 44117
Phone (216) 261-6263

25301 Euclid Ave
#2
Euclid, OH 44117

6780 Mayfield Rd
Ste 447
Mayfield Heights, OH 44124
Phone (216) 261-6263

6770 Mayfield Rd
Ste 447
Mayfield Heights, OH 44124
Phone (216) 545-4006

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1191456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282608000000",
    "number": "1700074770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25301 EUCLID AVE",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441172609",
            "telephone_number": "216-261-6263",
            "fax_number": "216-262-4964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25301 EUCLID AVE",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441172609",
            "telephone_number": "216-261-6263",
            "fax_number": "216-262-4964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEVELAND KIDNEY & HYPERTENSION CONSULTANTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-04",
        "last_updated": "2010-08-24",
        "status": "A",
        "authorized_official_last_name": "DICKARD",
        "authorized_official_first_name": "JAN",
        "authorized_official_title_or_position": "BILLING CLERK",
        "authorized_official_telephone_number": "216-261-6263"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2784876",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CKHC Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Euclid, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.