Active NPI
Kaelynn Workman
- Dermatology Physician
- Cleveland, OH
National Provider Identifier
1902645765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 57.257437
- Practice address
- 2049 E 100TH St
Cleveland, OH 44106-2104 - Phone
- (330) 348-3131
- NPI assigned
- May 22, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 57.257437 | OH | Primary |
Addresses
Primary practice location
2049 E 100TH St
Cleveland, OH 44106-2104
Mailing address
10001 Chester Ave
Cleveland, OH 44106-1617
Phone (330) 348-3131
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240606002777 | OH | Order and Referring Only - Dermatology | 7810439700 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 57.257437 | OH | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1716336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716336000000",
"number": "1902645765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10001 CHESTER AVE",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441061617",
"telephone_number": "330-348-3131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2049 E 100TH ST",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441062104",
"telephone_number": "330-348-3131"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WORKMAN",
"first_name": "KAELYNN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-05-22",
"last_updated": "2024-05-22",
"certification_date": "2024-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "OH",
"license": "57.257437",
"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 May 22, 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.