Organization Active NPI

Cedarnile LLC

  • Internal Medicine Physician
  • Lakewood, OH
National Provider Identifier
1942530506
Registry record updated Jan 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CEDARNILE LLC
Practice address
14805 Detroit Ave
Lakewood, OH 44107-3934
Phone
(330) 576-5600
NPI assigned
Jan 5, 2010
Last updated
Jan 11, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2010

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

Authorized official

Name
Dr. Samir Joseph Shaia, DO
Title
Partnership
Phone
(330) 567-5600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

14805 Detroit Ave
Lakewood, OH 44107-3934

Mailing address

PO Box 1243
Bath, OH 44210-1243
Phone (330) 576-5600

Other identifiers 1

IdentifierTypeStateIssuer
2474979MedicaidOH

National Provider Directory

National Provider Directory
Tax ID family
Cedarnile LLC2 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.

NPI Registry JSON

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

{
    "created_epoch": "1262649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263168000000",
    "number": "1942530506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1243",
            "city": "BATH",
            "state": "OH",
            "postal_code": "442101243",
            "telephone_number": "330-576-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14805 DETROIT AVE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441073934",
            "telephone_number": "330-576-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDARNILE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-05",
        "last_updated": "2010-01-11",
        "status": "A",
        "authorized_official_last_name": "SHAIA",
        "authorized_official_first_name": "SAMIR",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PARTNERSHIP",
        "authorized_official_telephone_number": "330-567-5600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2474979",
            "state": "OH"
        }
    ],
    "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 Jan 11, 2010; 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.