Cleveland Medical Management LLC
Organization Active NPI Nephrology Physician · Lebanon, OH
NPI 1730929464 · NPPES record last updated May 30, 2024
Key facts
- NPI
- 1730929464
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Nephrology Physician 207RN0300X
- Legal business name
- CLEVELAND MEDICAL MANAGEMENT LLC
- Practice address
- 700 Monroe Rd
Lebanon, OH 45036-1409 - Phone
- (513) 465-6268
- NPI assigned
- May 30, 2024
- Organization subpart
- No
Authorized official
- Name
- Corby Johnson
- Title
- VP
- Phone
- (513) 465-6268
Other NPIs on the same Medicare enrollment 1
Corporate family (same tax ID) 2
Practitioners 21
-
Alisha Ann Brown, CNP
-
Amirah Davis, CNP
-
Falisha L Lee, NP
-
Joanna Overholt, CNP
-
Christina R Sherrod, APRN
-
Richard I Sternberg, D.O.
-
Chimezie C Amanambu, M.D.
-
Harigopal Balaji, MD
-
Erin Marie Gerken, CNP
-
Page Hefner, APRN FNP-C
-
Abraham Olagoke Kuranga, M.D.
-
Andrew E Lazar, MD
-
Jessica Nicole Poe, NP-C
-
Jessica Fern, CNP
-
Angela L Smith, FNP
-
Carey Ann Susi, APRN-CNP
-
Abdullah Arshad, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20241016003126 | OH | Part B Supplier - Clinic/Group Practice | 1052843927 |
Receives reassigned benefits from 21 practitioners 1 other NPI on this enrollment Practice locations: Ravenna, OH; Oakwood Village, OH; Lorain, OH; Lebanon, OH; Hamilton, OH; Franklin, OH; Middleburg HTS, OH |
National Provider Directory
- Tax ID family
- Cleveland Medical Management LLC
Locations
1926 Ridge Ave SE
Warren, OH 44484
Phone (330) 219-0959
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician |
207RC0000X | |||
| Endocrinology, Diabetes & Metabolism Physician |
207RE0101X | |||
| Nephrology Physician |
207RN0300X | Yes |
Addresses
Primary practice location
700 Monroe Rd
Lebanon, OH 45036-1409
Mailing address
PO Box 286
Trenton, OH 45067-0286
Other providers in Lebanon, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 30, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.