NPIMap

Organization Active NPI

Ko Nurse Practitioner, LLC

  • Nurse Practitioner
  • Lakewood, OH
National Provider Identifier
1912287624
Registry record updated Sep 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
KO NURSE PRACTITIONER, LLC
Practice address
15800 Detroit Ave
Lakewood, OH 44107-3748
Phone
(216) 226-8700
NPI assigned
Aug 25, 2011
Last updated
Sep 20, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2016

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

Authorized official

Name
Dr. George Khuri, MDNPI 1760459978
Title
Owner
Phone
(216) 521-2255

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Nurse Practitioner 363L00000X NU Primary

Addresses

Primary practice location

15800 Detroit Ave
Lakewood, OH 44107-3748

Mailing address

PO Box 74692
Cleveland, OH 44194-0775

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1314230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474329600000",
    "number": "1912287624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 74692",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441940775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15800 DETROIT AVE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441073748",
            "telephone_number": "216-226-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KO NURSE PRACTITIONER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-25",
        "last_updated": "2016-09-20",
        "status": "A",
        "authorized_official_last_name": "KHURI",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "216-521-2255",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2016; 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.