NPIMap

Organization Active NPI

Psychiatry Networks Inc

  • Psychiatry Physician
  • Cleveland, OH
National Provider Identifier
1992045108
Registry record updated Mar 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
10292 Issued in ND
Legal business name
PSYCHIATRY NETWORKS INC
Practice address
5158 Broadway Ave
Cleveland, OH 44127
Phone
(216) 341-0070
Fax
(216) 341-0099
NPI assigned
Feb 25, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2019

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

Authorized official

Name
David J Lopez, MDNPI 1275629719
Title
President
Phone
(701) 478-6700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 10292 ND Primary

Addresses

Primary practice location

5158 Broadway Ave
Cleveland, OH 44127

Mailing address

5158 Broadway Ave
Cleveland, OH 44127-1592
Phone (216) 341-0070

Other practice location 1

300 Np Ave N
Suite 101
Fargo, ND 58102-4871
Phone (701) 478-6700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, MN, OH3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20131118001024 ND Part B Supplier - Clinic/Group Practice 0244466449 Receives reassigned benefits from 4 practitioners
Practice locations: Dickinson, ND
O20140206000765 MN Part B Supplier - Clinic/Group Practice 0244466449 Receives reassigned benefits from 1 practitioner
Practice locations: Breckinridge, MN; Little Falls, MN; Onamia, MN
O20190613000687 OH Part B Supplier - Clinic/Group Practice 0244466449 Receives reassigned benefits from 3 practitioners
Practice locations: Cleveland, OH

National Provider Directory

National Provider Directory

Locations

300 Np Ave N
Ste 101
Fargo, ND 58102
Phone (701) 478-6700

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1361750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553126400000",
    "number": "1992045108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5158 BROADWAY AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441271592",
            "telephone_number": "216-341-0070",
            "fax_number": "216-341-0099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5158 BROADWAY AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44127",
            "telephone_number": "216-341-0070",
            "fax_number": "216-341-0099"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Np Ave N",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581024871",
            "country_code": "US",
            "telephone_number": "701-478-6700",
            "fax_number": "701-478-6705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PSYCHIATRY NETWORKS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-25",
        "last_updated": "2019-03-21",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "701-478-6700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ND",
            "license": "10292",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Mar 21, 2019; 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.