Organization Active NPI

Northeast Ohio Anesthesia, LLC.

  • Specialist
  • Beachwood, OH
National Provider Identifier
1992758023
Registry record updated Jul 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
NORTHEAST OHIO ANESTHESIA, LLC.
Practice address
3755 Orange PL
Beachwood, OH 44122-4426
Phone
(330) 602-0767
NPI assigned
May 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2011

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

Authorized official

Name
Dr. Charles V Barrett, D.O.
Title
Vice President
Phone
(330) 602-0767

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

3755 Orange PL
Beachwood, OH 44122-4426

Mailing address

659 Boulevard St
Dover, OH 44622-2026
Phone (330) 602-0767

Other identifiers 1

IdentifierTypeStateIssuer
2306338MedicaidOH

National Provider Directory

National Provider Directory

Locations

3755 Orange Pl
Ste 103
Beachwood, OH 44122
Phone (216) 593-0030

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310947200000",
    "number": "1992758023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "659 BOULEVARD ST",
            "city": "DOVER",
            "state": "OH",
            "postal_code": "446222026",
            "telephone_number": "330-602-0767",
            "fax_number": "330-365-3831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3755 ORANGE PL",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441224426",
            "telephone_number": "330-602-0767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST OHIO ANESTHESIA, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2011-07-18",
        "status": "A",
        "authorized_official_last_name": "BARRETT",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "330-602-0767",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2306338",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2011; 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.