Richard So, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

35090551 Issued in OH

Practice address

20800 Westgate Mall
Suite 400
Fairview Park, OH 44126-1323

Phone

(440) 356-2272

Fax

(440) 356-2299

NPI assigned

Jul 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919
  Medicare reassignment NPD
• Clinic Regional Physicians LLC

  • Internal Medicine Physician
  • Beachwood, OH
  • NPI 1043470453

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231545600000",
    "number": "1962428557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20800 WESTGATE MALL",
            "address_2": "SUITE 400",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441261323",
            "telephone_number": "440-356-2272",
            "fax_number": "440-356-2299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20800 WESTGATE MALL",
            "address_2": "SUITE 400",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441261323",
            "telephone_number": "440-356-2272",
            "fax_number": "440-356-2299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SO",
        "first_name": "RICHARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2009-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35090551",
            "primary": true
        },
        {
            "code": "207RS0010X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sports Medicine",
            "state": "OH",
            "license": "35090551",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "000000536776",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE",
            "identifier": "340714618243",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2780745",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaitlyn Elizabeth Smith
• Mallory Krolikowski Smith, MT-BC, LPCC
• Neil P Smith, DO
• Todd W Smith, D.C.
• Snow Haven Counseling, LLC
• Sola Caritas
• Sara Solet, M.A.,CCC-SLP
• Michaela Toth Sommerfeld, PT, DPT
• Southwest General Health Center
• Southwest General Home Health LLC

• Pediatrics Physician in Fairview Park, OH
• Providers in Fairview Park, OH by specialty
• Pediatrics Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.