Individual provider Active NPI

Chenita Arlene Fairly, RN

  • Registered Nurse
  • Cleveland, OH
National Provider Identifier
1891008512
Registry record updated Jul 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
319678 Issued in OH
Practice address
10515 Norman Ave
Cleveland, OH 44106-4228
Phone
(216) 791-5818
NPI assigned
Jul 22, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2010

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 319678 OH Primary

Addresses

Primary practice location

10515 Norman Ave
Cleveland, OH 44106-4228

Mailing address

10515 Norman Ave
Cleveland, OH 44106-4228
Phone (216) 791-5818

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
319678OHMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1279756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279756800000",
    "number": "1891008512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10515 NORMAN AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441064228",
            "telephone_number": "216-791-5818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10515 NORMAN AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441064228",
            "telephone_number": "216-791-5818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRLY",
        "first_name": "CHENITA",
        "middle_name": "ARLENE",
        "name_prefix": "Miss",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-22",
        "last_updated": "2010-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "319678",
            "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 22, 2010; 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.