Elyria Internal Medicine, Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

ELYRIA INTERNAL MEDICINE, INC

Practice address

125 E Broad St
Ste 202
Elyria, OH 44035-6400

Phone

(440) 329-7306

Fax

(440) 329-7798

NPI assigned

Oct 13, 2009

Organization subpart

No

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

Authorized official

Name

Niraj C Mistry, MD

Title

Managing Partner

Phone

(440) 329-7306

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• William H Noble III, DO

  • Diagnostic Radiology Physician
  • Cleveland, OH
  • NPI 1619915469
  NPD (past)

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

{
    "created_epoch": "1255392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395619200000",
    "number": "1962737783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 E BROAD ST",
            "address_2": "STE 202",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440356400",
            "telephone_number": "440-329-7306",
            "fax_number": "440-329-7798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 E BROAD ST",
            "address_2": "STE 202",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440356400",
            "telephone_number": "440-329-7306",
            "fax_number": "440-329-7798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELYRIA INTERNAL MEDICINE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-13",
        "last_updated": "2014-03-24",
        "status": "A",
        "authorized_official_last_name": "MISTRY",
        "authorized_official_first_name": "NIRAJ",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "440-329-7306",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3029565",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elyria Eye Clinic Inc
• Elyria Foot Clinic Inc.
• Elyria Group Homes, Inc.
• Elyria Icf II,LLC
• Elyria Icf, LLC
• Elyria Large Group Homes, Inc.
• Elyria Medical Center LLC
• Elyria Mediclinic
• Elyria Obstetrics & Gynecology Inc
• Elyria Township Trustee

• Internal Medicine Physician in Elyria, OH
• Providers in Elyria, OH by specialty
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2014; 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.