PROVIDERGENIX LLC NPI 1194327098

NPI Information

NPI: 1194327098
Provider Name: PROVIDERGENIX LLC
Classification: Nurse Practitioner - 363LP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
3100 E 45TH ST STE 234
CLEVELAND, OH
ZIP 44127
Phone: (419) 406-0067
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PROVIDERGENIX LLC is a primary care nurse practitioner in Cleveland, OH. PROVIDERGENIX LLC NPI is 1194327098. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3100 E 45TH ST STE 234
CLEVELAND, OH
ZIP 44127-091
Phone: (419) 406-0067
Fax: (866) 309-3044

The provider's authorized official is Thomas Lee Russell .
The authorized official title is Ceo and has the following contact phone number (419) 406-0067.

The enumeration date for this NPI number is 11/15/2020 and was last updated on 11/15/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	163W00000X	Registered Nurse		No
2	163WA0400X	Registered Nurse	Addiction (Substance Use Disorder)	No
3	163WG0000X	Registered Nurse	General Practice	No
4	163WH0200X	Registered Nurse	Home Health	No
5	163WI0500X	Registered Nurse	Infusion Therapy	No
6	163WP0808X	Registered Nurse	Psychiatric/Mental Health	No
7	207Q00000X	Family Medicine		No
8	207R00000X	Internal Medicine		No
9	2084P0800X	Psychiatry & Neurology	Psychiatry	No
10	2084P0802X	Psychiatry & Neurology	Addiction Psychiatry	No
11	363A00000X	Physician Assistant		No
12	363L00000X	Nurse Practitioner		No
13	363LP2300X	Nurse Practitioner	Primary Care	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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