Individual provider Active NPI

Susan Clark Rath, PA-C

  • Surgical Physician Assistant
  • Beachwood, OH
National Provider Identifier
1790884625
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
1021833 Issued in OH
Practice address
3401 Enterprise Pkwy
Suite 300
Beachwood, OH 44122-7341
Phone
(216) 221-2878
NPI assigned
Sep 21, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 1021833 OH Primary

Addresses

Primary practice location

3401 Enterprise Pkwy
Suite 300
Beachwood, OH 44122-7341

Mailing address

3401 Enterprise Pkwy
Suite 300
Beachwood, OH 44122-7341
Phone (216) 221-2878

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1021833OHMDSurgical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1790884625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 ENTERPRISE PKWY",
            "address_2": "SUITE 300",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441227341",
            "telephone_number": "216-221-2878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 ENTERPRISE PKWY",
            "address_2": "SUITE 300",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441227341",
            "telephone_number": "216-221-2878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK RATH",
        "first_name": "SUSAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OH",
            "license": "1021833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.