NPIMap

Organization Active NPI

Northeast Ohio Neighborhood Health Services, Inc.

  • Primary Care Clinic/Center
  • Cleveland, OH
National Provider Identifier
1922112960
Registry record updated Apr 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
NORTHEAST OHIO NEIGHBORHOOD HEALTH SERVICES, INC.
Practice address
13301 Miles Ave
Cleveland, OH 44105-5521
Phone
(216) 751-3100
Fax
(216) 751-2480
NPI assigned
Aug 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2008

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

Authorized official

Name
Mr. Willie F. Austin
Title
President & Ceo
Phone
(216) 231-7700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

13301 Miles Ave
Cleveland, OH 44105-5521

Mailing address

13301 Miles Ave
Cleveland, OH 44105-5521
Phone (216) 751-3100

Other identifiers 1

IdentifierTypeStateIssuer
0159920MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040804000672 OH Part B Supplier - Public Health/Welfare Agency 5799756615 Receives reassigned benefits from 40 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cleveland, OH; E Cleveland, OH

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

4800 Payne Ave
Cleveland, OH 44103
Phone (216) 231-7700

Practitioners & affiliated clinicians

Practitioners 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207872000000",
    "number": "1922112960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13301 MILES AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441055521",
            "telephone_number": "216-751-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13301 MILES AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441055521",
            "telephone_number": "216-751-3100",
            "fax_number": "216-751-2480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST OHIO NEIGHBORHOOD HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2008-04-11",
        "status": "A",
        "authorized_official_last_name": "AUSTIN",
        "authorized_official_first_name": "WILLIE",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "216-231-7700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0159920",
            "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 Apr 11, 2008; 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.