GREEN ROAD PEDIATRICS, INC. (NPI# 1396822847) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396822847 |
| Entity Type | Organization |
| Organization Name | GREEN ROAD PEDIATRICS, INC. |
| Practice Address |
1611 S Green Rd Suite 035 South Euclid OH 44121-4128 |
| Practice Telephone | 2163823800 |
| Practice Fax Number | 2163815198 |
| Mailing Telephone | 2163823800 |
| Mailing Fax Number | 2163815198 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. JAMES T. LESLIE (PRESIDENT) |
| Authorized Official Telephone | 2163823800 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2129637 | 05 |
| Street Address |
1611 S GREEN RD SUITE 035 |
| City | SOUTH EUCLID |
| State | OH |
| Zip Code | 44121-4128 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154325983 | Michael Patrick Varley | Ophthalmology | 1611 S Green Rd, South Euclid, OH 44121-4129 | 2005-06-09 |
| 1639783467 | Regan E Shanahan | Physical Therapist | 1611 S Green Rd, South Euclid, OH 44121-4129 | 2020-08-31 |
| 1619313970 | Nicholas Freeman Volchko | Anesthesiology | 1611 S Green Rd, South Euclid, OH 44121-4129 | 2013-05-14 |
| 1689910739 | The Endoscopy Center At Bainbridge, LLC | Clinic/Center | 1611 S Green Rd, South Euclid, OH 44121-4129 | 2012-12-18 |
| 1801151477 | Ryan Daniel Supler | Physical Therapist | 1611 S Green Rd, Suite 036, South Euclid, OH 44121-4129 | 2012-07-10 |
| 1750654414 | John M Campolieti | Physical Therapist | 1611 S Green Rd, Suite 036, South Euclid, OH 44121-4129 | 2012-02-10 |
| 1437454477 | University Hospitals Medical Group, Inc. | Surgery | 1611 S Green Rd, Suite 107, South Euclid, OH 44121-4129 | 2011-01-24 |
| 1477858645 | Mickie Guarino Newland | Physical Therapist | 1611 S Green Rd, Suite 036, South Euclid, OH 44121-4129 | 2011-01-20 |
| 1477862571 | University Hospitals Medical Group, Inc. | Psychiatry & Neurology | 1611 S Green Rd, Suite 204, South Euclid, OH 44121-4129 | 2010-10-07 |
| 1932418746 | University Hospitals Medical Group, Inc. | Urology | 1611 S Green Rd, Suite 106, South Euclid, OH 44121-4129 | 2010-09-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396213443 | Khrystyne Hill | Home Health Aide | 1396 Villa Dr, South Euclid, OH 44121 | 2018-11-07 |
| 1700369329 | An Angels Touch | Case Manager/Care Coordinator | 4673 Liberty Road, South Euclid, OH 44121 | 2018-09-10 |
| 1336654169 | Dawn Marniece Burns | Counselor | 2490 Noble Rd Ste 101, Cleveland Heights, OH 44121 | 2017-12-01 |
| 1154830610 | Kamry Wilson | Massage Therapist | 1915 Temblethurst Rd, South Euclid, OH 44121 | 2017-09-27 |
| 1891210027 | Tyrone Sykes | Counselor | 2940 Noble Rd, Cleveland Hts, OH 44121 | 2017-08-09 |
| 1083140412 | Cortney Casey | Licensed Practical Nurse | 3430 Monticello Blvd, Cleveland Heights, OH 44121 | 2017-05-04 |
| 1821523374 | Sharmila Noles | Licensed Practical Nurse | 818 South Green Rd, 5, South Euclid, OH 44121 | 2017-04-21 |
| 1679018725 | Safe Haven Residential Services | In Home Supportive Care | 2515 Belvoir Rd, Cleveland, OH 44121 | 2016-12-28 |
| 1447702154 | Jerry C Mallory Jr. | Military Health Care Provider | 4018 Bayard 44121, Apo, AA 44121 | 2016-10-28 |
| 1215388129 | Rose-mary, The Johanna Grasselli Rehabilitation and Education Center | Intermediate Care Facility, Mentally Retarded | 4383 Ammon Road, South Euclid, OH 44121 | 2016-06-22 |
| Find all providers in zip 44121 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| 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. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134565757 | Allison Effron | Pediatrics | 2054 S. Green Road, South Euclid, OH 44121 | 2013-05-22 |
| 1770807828 | Rachel M Garber Md Inc | Pediatrics | 1611 S Green Rd, Suite 034, South Euclid, OH 44121-4128 | 2010-03-18 |
| 1033381462 | Dr. Shelly David Senders, Md, Inc | Pediatrics | 2054 South Green Road, South Euclid, OH 44121 | 2008-03-26 |
| 1518982735 | Rachel Mirian Garber | Pediatrics | 1611 S Green Rd, Suite 034, South Euclid, OH 44121-4128 | 2006-07-12 |
| 1164488813 | Elizabeth Z Bucchieri | Pediatrics | 2054 South Green Road, South Euclid, OH 44121 | 2006-04-21 |
| 1194781906 | Jill A Sangree | Pediatrics | 2054 South Green Road, South Euclid, OH 44121 | 2006-04-21 |
| 1629030242 | Shelly David Senders | Pediatrics | 2054 South Green Road, South Euclid, OH 44121 | 2006-04-06 |
| 1093795916 | Kelly Lyn Westbrooks Joyce | Pediatrics | 1611 S Green Rd, Suite 035, South Euclid, OH 44121-4128 | 2006-01-18 |
| 1356320162 | Elizabeth Leah Hellerstein | Pediatrics | 1611 S Green Rd, Suite 035, South Euclid, OH 44121-4128 | 2006-01-10 |
| 1972594760 | Alexander Harold Namrow | Pediatrics | 1611 S Green Rd, South Euclid, OH 44121-4128 | 2005-11-02 |
| Find all providers in SOUTH EUCLID | ||||
| City | SOUTH EUCLID |
| Zip Code | 44121 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.