PROSEARCH HEALTHCARE, INC. - NPI NUMBER 1982789988

Summary

Provider Name: PROSEARCH HEALTHCARE, INC.

NPI Number: 1982789988

Clasification: Nurse Practitioner (363L00000X)

Address:
3780 MEDINA RD STE 110
MEDINA, OH
ZIP 44256

Phone Number: (216) 406-4323



Detailed Information

PROSEARCH HEALTHCARE, INC. is a nurse practitioner in Medina, OH. The provider is (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. The assigned NPI number for this provider is 1982789988 and is registered as an organization entity type and is a single specialty group.

The provider's business address is:

3780 MEDINA RD STE 110
MEDINA, OH
ZIP 44256-312
Phone: (216) 406-4323

The provider's authorized official is Laurie Mandel .
The authorized official title is President and has the following contact phone number (216) 406-4323.

The enumeration date for this NPI number is 10/26/2006 and was last updated on 7/26/2012.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 363L00000X Nurse Practitioner NP-02671 OH Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 Q27820 MEDICARE ID-TYPE UNSPECIFIED OH

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1982789988 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 2 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Employer Identification Number EIN The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
4 Provider Organization Name Legal Business Name PROSEARCH HEALTHCARE, INC. The name of the organization provider. If the provider is an organization, this is the legal business name.
5 Provider First Line Business Practice Location Address 3780 MEDINA RD STE 110 The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
6 Provider Business Practice Location Address City Name MEDINA The city name in the location address of the provider being identified.
7 Provider Business Practice Location Address State Name OH The State code in the location of the provider being identified.
8 Provider Business Practice Location Address Postal Code 442569312 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
9 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
10 Provider Business Practice Location Address Telephone Number 2164064323 The telephone number associated with the location address of the provider being identified.
11 Provider Enumeration Date 10/26/2006 The date the provider was assigned a unique identifier (assigned an NPI).
12 Last Update Date 7/26/2012 The date that a record was last updated or changed.
13 Authorized Official Last Name MANDEL The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
14 Authorized Official First Name LAURIE The first name of the authorized official.
15 Authorized Official Title or Position PRESIDENT The title or position of the authorized official.
16 Authorized Official Telephone Number 2164064323 The 10-position telephone number of the authorized official.
17 Healthcare Provider Taxonomy Code 1 363L00000X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
18 Provider License Number 1 NP-02671 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
19 Provider License Number State Code 1 OH The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
20 Healthcare Provider Primary Taxonomy Switch 1 Y
21 Other Provider Identifier 1 Q27820 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
22 Other Provider Identifier Type Code 1 04 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
23 Other Provider Identifier State 1 OH
24 Is Organization Subpart N
25 Healthcare Provider Taxonomy Group 1 193400000X SINGLE SPECIALTY GROUP

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This page was last updated on: 3/10/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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