Organization Active NPI

Woodmere Village

  • Ambulance
  • Cleveland, OH
National Provider Identifier
1912045964
Registry record updated Jun 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
Legal business name
WOODMERE VILLAGE
Practice address
27899 Chagrin Blvd
Cleveland, OH 44122
Phone
(216) 831-9511
Fax
(216) 292-7033
NPI assigned
Feb 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2018

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

Authorized official

Name
Ms. Benjamin I. Holbert
Title
Mayor
Phone
(216) 831-9511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X Primary

Addresses

Primary practice location

27899 Chagrin Blvd
Cleveland, OH 44122

Mailing address

27899 Chagrin Blvd
Cleveland, OH 44122-4427
Phone (216) 831-9511

Other identifiers 1

IdentifierTypeStateIssuer
2247269MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040528001287 OH Part B Supplier - Ambulance Service Supplier 4183605660 Practice locations: Cleveland, OH

National Provider Directory

National Provider Directory
Tax ID family
Villege of Woodmere2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

27899 Chagrin Blvd
Woodmere, OH 44122
Phone (216) 292-4103

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528848000000",
    "number": "1912045964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27899 CHAGRIN BLVD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441224427",
            "telephone_number": "216-831-9511",
            "fax_number": "216-292-7033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27899 CHAGRIN BLVD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44122",
            "telephone_number": "216-831-9511",
            "fax_number": "216-292-7033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODMERE VILLAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2018-06-13",
        "status": "A",
        "authorized_official_last_name": "HOLBERT",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "I.",
        "authorized_official_title_or_position": "MAYOR",
        "authorized_official_telephone_number": "216-831-9511",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2247269",
            "state": "OH"
        }
    ],
    "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 Jun 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.