Charles Henri Mbala Ondobo, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

020795 Issued in OH

Practice address

13719 Lorain Ave
Cleveland, OH 44111-3439

Phone

(216) 307-3005

Fax

(216) 710-5360

NPI assigned

May 15, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH, MA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: charles.ondobofnp.p1@direct.neon.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Northeast Ohio Neighborhood Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Cleveland, OH
  • NPI 1851302665

  OH

  Medicare reassignment NPD
• Dedicated Ohio Holding LLC

  • Internal Medicine Physician
  • Miami, FL
  • NPI 1922631019

  OH

  Medicare reassignment NPD
• Dedicated Ohio Holding LLC

  • Non-Pharmacy Dispensing Site
  • Cleveland, OH
  • NPI 1295368397
  NPD
• Northeast Ohio Neighborhood Health Services, Inc.

  • Primary Care Clinic/Center
  • Cleveland, OH
  • NPI 1508877739
  NPD
• Northeast Ohio Neighborhood Health Services, Inc.

  • Primary Care Clinic/Center
  • Cleveland, OH
  • NPI 1922112960
  NPD
• Northeast Ohio Neighborhood Health Services, Inc.

  • Primary Care Clinic/Center
  • Cleveland, OH
  • NPI 1952417891
  NPD

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

{
    "created_epoch": "1494806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1861929465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13719 LORAIN AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441113439",
            "telephone_number": "216-307-3005",
            "fax_number": "216-710-5360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13719 LORAIN AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441113439",
            "telephone_number": "216-307-3005",
            "fax_number": "216-710-5360"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19570 Euclid Ave Apt 300",
            "address_purpose": "LOCATION",
            "city": "Euclid",
            "state": "OH",
            "postal_code": "441171434",
            "country_code": "US",
            "telephone_number": "240-643-2864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ONDOBO",
        "first_name": "CHARLES HENRI",
        "middle_name": "MBALA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-15",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "020795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Onco Diagnostic Laboratory
• Mariah Ondeck
• Chanel Nicole Ondecker, CNP
• Raymond P Onders, MD
• Shannon Ellen Onders, RD, LD
• Jason Edward Ondrejka, DO
• Sarah Lynn Ondrejka, D.O.
• Lindsay Marie Ondrey, PA-C
• Paul Ondus
• One Child Every Chance Foundation LLC

• All providers in Cleveland, OH
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.