Olympia Medical Clinic

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35034747 Issued in OH

Legal business name

OLYMPIA MEDICAL CLINIC

Practice address

3361 E 55TH St
Cleveland, OH 44127-1547

Phone

(216) 441-0660

Fax

(216) 441-0660

NPI assigned

Sep 23, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Ruben T Agra, M.D.

Title

Doctor

Phone

(216) 441-0660

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Lolita R Agra, M.D.

  • Family Medicine Physician
  • Cleveland, OH
  • NPI 1467633727
  NPD (past)

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

{
    "created_epoch": "1411430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411430400000",
    "number": "1891197786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3361 E 55TH ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441271547",
            "telephone_number": "216-441-0660",
            "fax_number": "216-441-0660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3361 E 55TH ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441271547",
            "telephone_number": "216-441-0660",
            "fax_number": "216-441-0660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLYMPIA MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-23",
        "last_updated": "2014-09-23",
        "status": "A",
        "authorized_official_last_name": "AGRA",
        "authorized_official_first_name": "RUBEN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "216-441-0660",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35034747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0719824",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mircea Olteanu, DDS
• Nicoleta Adina Olteanu, M.D.
• Denise Oltmanns, QMHS BA CM BA
• Chrislene Olukoga, MD
• Olatoye Olutola, M.D.
• Edward A Omabegho, MSW
• Karen Omalley, PCC-S
• Briana Oman
• Ahmed Farghaly Omar, M.D.
• Mahmoud Omar

• Family Medicine Physician in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2014; 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.