NPIMap

Organization Active NPI

St. Vincent Charity Medical Center

  • Student Health Clinic/Center
  • Cleveland, OH
National Provider Identifier
1790169381
Registry record updated Jul 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
Legal business name
ST. VINCENT CHARITY MEDICAL CENTER
Practice address
2351 E 22ND St
Suite 342W
Cleveland, OH 44115-3111
Phone
(316) 861-6200
Fax
(216) 363-7490
NPI assigned
Jul 14, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2015

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

Authorized official

Name
Dr. Dyron Mickey Holt, D.D.S.
Title
Dental Resident
Phone
(865) 250-8398

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student Health Clinic/Center 261QS1000X Primary

Addresses

Primary practice location

2351 E 22ND St
Suite 342W
Cleveland, OH 44115-3111

Mailing address

19425 Van Aken Blvd
Apt. 401
Shaker Heights, OH 44122-3547
Phone (216) 861-6200

National Provider Directory

National Provider Directory
Tax ID family
St Vincent Charity Medical Center7 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

2351 E 22nd St
Ste 342W
Cleveland, OH 44115
Phone (216) 363-2725

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1436832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436832000000",
    "number": "1790169381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19425 VAN AKEN BLVD",
            "address_2": "APT. 401",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441223547",
            "telephone_number": "216-861-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2351 E 22ND ST",
            "address_2": "SUITE 342W",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441153111",
            "telephone_number": "316-861-6200",
            "fax_number": "216-363-7490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. VINCENT CHARITY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-14",
        "last_updated": "2015-07-14",
        "status": "A",
        "authorized_official_last_name": "HOLT",
        "authorized_official_first_name": "DYRON",
        "authorized_official_middle_name": "MICKEY",
        "authorized_official_title_or_position": "DENTAL RESIDENT",
        "authorized_official_telephone_number": "865-250-8398",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": null,
            "license": null,
            "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 14, 2015; 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.