Barry a Koblentz DPM Inc

Primary specialty

PodiatristTaxonomy code 213E00000X

License

1541 Issued in OH

Legal business name

BARRY A KOBLENTZ DPM INC

Practice address

5035 Mayfield Rd
215
Lyndhurst, OH 44124-2688

Phone

(216) 291-1515

NPI assigned

Aug 12, 2006

Last updated

Dec 10, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Barry Alan Koblentz, DPM

Title

President

Phone

(216) 291-1515

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197244800000",
    "number": "1982616835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5035 MAYFIELD RD",
            "address_2": "215",
            "city": "LYNDHURST",
            "state": "OH",
            "postal_code": "441242688",
            "telephone_number": "216-291-1515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5035 MAYFIELD RD",
            "address_2": "215",
            "city": "LYNDHURST",
            "state": "OH",
            "postal_code": "441242688",
            "telephone_number": "216-291-1515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BARRY A KOBLENTZ DPM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-12",
        "last_updated": "2007-12-10",
        "status": "A",
        "authorized_official_last_name": "KOBLENTZ",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "216-291-1515",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "1541",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2743311",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Podiatrist in Lyndhurst, OH
• Providers in Lyndhurst, OH by specialty
• Podiatrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2007; 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.