Active NPI
Alisa P Nammavong, FNP-BC
- Nurse Practitioner
- Cleveland, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- APRN.CNP.0027355
- Practice address
- 9500 Euclid Ave
Cleveland, OH 44195-4299 - Phone
- (216) 444-2200
- NPI assigned
- Aug 13, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | APRN.CNP.0027355 | OH | Primary |
| Family Nurse Practitioner | 363LF0000X | APRN.CNP.0027355 | OH |
Addresses
Primary practice location
9500 Euclid Ave
Cleveland, OH 44195-4299
Mailing address
9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-2000
Other practice location 1
4235 Secor Rd
Toledo, OH 43623-4299
Phone (419) 473-3561
Other practice location 2
3000 Arlington Ave
Toledo, OH 43614-2598
Phone (419) 383-4000
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-5433
Hospital & facility affiliations
- Cleveland Clinic Home Care
- Cleveland Clinic
- Hillcrest Hospital
- Euclid Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN.CNP.0027355 | OH | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical University of Ohio at Toledo | Current | Accepting new patients | |
| The Little Clinic of Ohio LLC | Family | Current | Accepting new patients |
| The Cleveland Clinic Foundation | Current | Accepting new patients | |
| Toledo Clinic Incorporated | Past | Accepting new patients |
Locations
9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270
26900 Cedar Rd
Cleveland, OH 44122
Phone (216) 839-3000
199 Graceland Blvd
Columbus, OH 43214
Phone (614) 410-2814
27386 Carronade Dr
Perrysburg, OH 43551
Phone (419) 874-7014
6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363
3000 Arlington Ave
Toledo, OH 43614
Phone (419) 383-3556
Interoperability endpoints
- anammavong24967@direct.utoledo.edu
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Acute Care Hospital
- Cleveland, OH
- NPI 1679525919
-
- Family Nurse Practitioner
- Cincinnati, OH
- NPI 1982761896
-
- General Acute Care Hospital
- Toledo, OH
- NPI 1811971302
-
- Podiatrist
- Toledo, OH
- NPI 1457346462
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Independence, OH
- NPI 1225009442
-
- General Acute Care Hospital
- Euclid, OH
- NPI 1598719346
-
- General Acute Care Hospital
- Mayfield HTS, OH
- NPI 1902858152
-
- General Acute Care Hospital
- Cleveland, OH
- NPI 1679525919
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658966400000",
"number": "1912518788",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9500 EUCLID AVE",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441950001",
"telephone_number": "216-444-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9500 EUCLID AVE",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441954299",
"telephone_number": "216-444-2200"
}
],
"practiceLocations": [
{
"address_1": "4235 Secor Rd",
"address_purpose": "LOCATION",
"city": "Toledo",
"state": "OH",
"postal_code": "436234299",
"country_code": "US",
"telephone_number": "419-473-3561",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3000 Arlington Ave",
"address_purpose": "LOCATION",
"city": "Toledo",
"state": "OH",
"postal_code": "436142598",
"country_code": "US",
"telephone_number": "419-383-4000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NAMMAVONG",
"first_name": "ALISA",
"middle_name": "P",
"credential": "FNP-BC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-08-13",
"last_updated": "2022-07-28",
"certification_date": "2022-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "OH",
"license": "APRN.CNP.0027355",
"primary": true
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OH",
"license": "APRN.CNP.0027355",
"primary": false
}
],
"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 28, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.