Individual provider Active NPI

Mary Katherine Gaines

  • Registered Nurse
  • Cleveland, OH
National Provider Identifier
1780413047
Registry record updated Jul 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN.490874 Issued in OH
Practice address
9500 Euclid Ave
Cleveland, OH 44195-3127
Phone
(216) 444-2200
NPI assigned
Jul 26, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.490874 OH Primary

Addresses

Primary practice location

9500 Euclid Ave
Cleveland, OH 44195-3127

Mailing address

1711 Wrenford Rd
South Euclid, OH 44121-3127

Other practice location 1

1711 Wrenford Rd
South Euclid, OH 44121-3127
Phone (216) 319-1169

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN.490874OHMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1721952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1780413047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 WRENFORD RD",
            "city": "SOUTH EUCLID",
            "state": "OH",
            "postal_code": "441213127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441953127",
            "telephone_number": "216-444-2200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1711 Wrenford Rd",
            "address_purpose": "LOCATION",
            "city": "South Euclid",
            "state": "OH",
            "postal_code": "441213127",
            "country_code": "US",
            "telephone_number": "216-319-1169",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAINES",
        "first_name": "MARY",
        "middle_name": "KATHERINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-26",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.490874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 26, 2024; 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.