Eddairis Marie Vallejo, APRN-CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

024607 Issued in OH

Practice address

5209 Detroit Ave
Cleveland, OH 44102-2224

Phone

(216) 651-2037

Fax

(216) 651-4145

NPI assigned

Jun 4, 2019

Last updated

Jun 4, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Circle Health Services

  • Federally Qualified Health Center (FQHC)
  • Cleveland, OH
  • NPI 1386609857
  Medicare reassignment NPD
• The Metrohealth System

  dba Metrohealth Professional Group

  • Multi-Specialty Clinic/Center
  • Cleveland, OH
  • NPI 1053353896
  Medicare reassignment NPD
• Intensive Care Experts Health Network LLC

  • Pulmonary Disease Physician
  • Hallandale Beach, FL
  • NPI 1164824397

  OH

  Medicare reassignment NPD
• Woundworks LLC

  • Nurse Practitioner
  • Lakewood, NJ
  • NPI 1093303273

  OH

  Medicare reassignment NPD
• Community Care Health Network LLC

  dba Matrix Medical Network

  • Nurse Practitioner
  • Nashville, TN
  • NPI 1619368842

  OH

  Medicare reassignment
• Circle Health Services

  dba The Centers

  • Federally Qualified Health Center (FQHC)
  • Cleveland, OH
  • NPI 1396552949
  NPD
• Intensive Care Experts Health Network LLC

  • Acute Care Nurse Practitioner
  • Columbus, OH
  • NPI 1396617841
  NPD
• The Metrohealth System

  dba MetroHealth Brooklyn Memphis Pharmacy

  • Pharmacy
  • Cleveland, OH
  • NPI 1992529911
  NPD
• Intensive Care Experts Health Network LLC

  • Acute Care Nurse Practitioner
  • Lawrenceburg, TN
  • NPI 1184596637
  NPD

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

{
    "created_epoch": "1559606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1750949780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5209 DETROIT AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441022224",
            "telephone_number": "216-651-2037",
            "fax_number": "216-651-4145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5209 DETROIT AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441022224",
            "telephone_number": "216-651-2037",
            "fax_number": "216-651-4145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLEJO",
        "first_name": "EDDAIRIS",
        "middle_name": "MARIE",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-04",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "024607",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "351707",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "kwillis@metrohealth.org",
            "affiliation": "N",
            "endpointDescription": "medical staff office Kendra willis",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "credentialing",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "MetroHealth",
            "address_1": "2500 Metrohealth Dr",
            "city": "Cleveland",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441091900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "eddairis.vallejo@thecentersohio.org",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "patient care management",
            "address_1": "5209 Detroit Ave",
            "city": "Cleveland",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441022224",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kimberley Vales, CNP
• Raquel Vales
• Raj P Vallabhaneni, MD
• Rajani V Vallabhaneni, M.D.
• Rangit Reddy Vallapureddy, MD
• Gabriel Vallejos, MD
• Carrie Ann Valletto
• Bonnie Lynn Vallie
• Heather A Vallier, MD
• Royson Valliyil, DO

• Family Nurse Practitioner in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.