NPIMap

Organization Active NPI

City of Cleveland

Doing business as Cleveland Department of Public Health, J. Glen Smith Treatment Program

  • Community/Behavioral Health Agency
  • Cleveland, OH
National Provider Identifier
1740345339
Registry record updated Oct 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
1073 Issued in OH
Legal business name
CITY OF CLEVELAND
Doing business as
Cleveland Department of Public Health, J. Glen Smith Treatment Program
Practice address
11100 Saint Clair Ave
J. Glen Smith Health Center
Cleveland, OH 44108-1943
Phone
(216) 664-3891
NPI assigned
Dec 26, 2006
Last updated
Oct 16, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2008

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

Authorized official

Name
Matt Carroll
Title
Director, CDPH
Phone
(216) 664-6790

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 1073 OH Primary

Addresses

Primary practice location

11100 Saint Clair Ave
J. Glen Smith Health Center
Cleveland, OH 44108-1943

Mailing address

1925 Saint Clair Ave NE
Cleveland Department of Public Health
Cleveland, OH 44114-2028
Phone (216) 664-3920

Other names 1

  • Cleveland Department of Public Health, J. Glen Smith Treatment Program Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180307002843 OH Part B Supplier - Clinic/Group Practice 2264346030 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
Practice locations: Cleveland, OH

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Cleveland Hopkins Int a7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

11100 Saint Clair Ave
#J
Cleveland, OH 44108
Phone (216) 664-2362

3466 Saint Roccos Ct
Ste 1
Cleveland, OH 44109

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224115200000",
    "number": "1740345339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 SAINT CLAIR AVE NE",
            "address_2": "CLEVELAND DEPARTMENT OF PUBLIC HEALTH",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441142028",
            "telephone_number": "216-664-3920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 SAINT CLAIR AVE",
            "address_2": "J. GLEN SMITH HEALTH CENTER",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441081943",
            "telephone_number": "216-664-3891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF CLEVELAND",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-26",
        "last_updated": "2008-10-16",
        "status": "A",
        "authorized_official_last_name": "CARROLL",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "DIRECTOR, CDPH",
        "authorized_official_telephone_number": "216-664-6790"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OH",
            "license": "1073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cleveland Department of Public Health, J. Glen Smith Treatment Program",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 16, 2008; 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.