Organization Active NPI

Two Brothers Enterprises Inc

  • Internal Medicine Physician
  • Independence, OH
National Provider Identifier
1851540280
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
TWO BROTHERS ENTERPRISES INC
Practice address
4400 Rockside Rd
Suite 2100
Independence, OH 44131-2168
Phone
(216) 573-1300
Fax
(216) 503-5005
NPI assigned
Sep 10, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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

Authorized official

Name
Lenore A Carver
Title
Office Manager
Phone
(216) 573-1300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

4400 Rockside Rd
Suite 2100
Independence, OH 44131-2168

Mailing address

4400 Rockside Rd
Suite 2100
Independence, OH 44131-2168
Phone (216) 573-1300

Other identifiers 2

IdentifierTypeStateIssuer
2878060MedicaidOH
000000590089OtherOHANTHEM BLUE SHIELD

Other names 1

  • Independence Urgent Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090202000174 OH Part B Supplier - Clinic/Group Practice 0143384438 Receives reassigned benefits from 2 practitioners
Practice locations: Independence, OH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D0883239Independence Urgent Care4400 Rockside Road Suite 2100, Independence, OH 44131Certificate of waiverOct 28, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1221004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600214400000",
    "number": "1851540280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 ROCKSIDE RD",
            "address_2": "SUITE 2100",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441312168",
            "telephone_number": "216-573-1300",
            "fax_number": "216-503-5005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 ROCKSIDE RD",
            "address_2": "SUITE 2100",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441312168",
            "telephone_number": "216-573-1300",
            "fax_number": "216-503-5005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TWO BROTHERS ENTERPRISES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-10",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A",
        "authorized_official_last_name": "CARVER",
        "authorized_official_first_name": "LENORE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "216-573-1300"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2878060",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE SHIELD",
            "identifier": "000000590089",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Independence Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Independence Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Independence, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.