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GREEN ROAD PEDIATRICS INC. NPI 1396822847


NPI Information

NPI: 1396822847
Provider Name: GREEN ROAD PEDIATRICS, INC.
Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
1611 S GREEN RD
SUITE 035
SOUTH EUCLID, OH
ZIP 44121
Phone: (216) 382-3800
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GREEN ROAD PEDIATRICS, INC. is a pediatrics in South Euclid, OH. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. GREEN ROAD PEDIATRICS, INC. NPI is 1396822847. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1611 S GREEN RD
SUITE 035
SOUTH EUCLID, OH
ZIP 44121-128
Phone: (216) 382-3800
Fax: (216) 381-5198

The provider's authorized official is James T. Leslie .
The authorized official title is President and has the following contact phone number (216) 382-3800.

The enumeration date for this NPI number is 11/1/2006 and was last updated on 8/22/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
12129637MEDICAIDOHIO

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

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