RIDGEPARK MEDICAL ASSOCIATES, INC. (NPI# 1407865488) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407865488 |
| Entity Type | Organization |
| Organization Name | RIDGEPARK MEDICAL ASSOCIATES, INC. |
| Practice Address |
7575 Northcliff Ave Laboratory Suite 106 Brooklyn OH 44144-3267 |
| Practice Telephone | 2163985095 |
| Practice Fax Number | 2163985119 |
| Mailing Telephone | 2163985095 |
| Mailing Fax Number | 2163985119 |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2011-08-31 |
| Authorized Official Name | CHARLES ROBERT KOEPKE (PRESIDENT) |
| Authorized Official Telephone | 2167498256 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | 36D0338463 | OH | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2754274 | 05 | |
| ANTHEM | 000000561755 | 01 | |
| OH | WELLCAREOF OH | 512593 | 01 |
| Street Address |
7575 NORTHCLIFF AVE LABORATORY SUITE 106 |
| City | BROOKLYN |
| State | OH |
| Zip Code | 44144-3267 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750373650 | Lawrence A Detwiler | Internal Medicine | 7575 Northcliff Ave, Suite 102, Brooklyn, OH 44144-3267 | 2005-08-17 |
| 1740890201 | Kellie King | Nurse Practitioner | 7575 Northcliff Ave, Brooklyn, OH 44144-3267 | 2020-08-08 |
| 1396399077 | Kimberly Annmarie Babich-speck | Nurse Practitioner | 7575 Northcliff Ave, Brooklyn, OH 44144-3267 | 2019-07-30 |
| 1578994042 | Molly Gumucio | Nurse Practitioner | 7575 Northcliff Ave, Brooklyn, OH 44144-3267 | 2013-12-09 |
| 1528311198 | Ridgepark Nurse Practitioners LLC | Nurse Practitioner | 7575 Northcliff Ave, Suite 400, Brooklyn, OH 44144-3267 | 2012-10-19 |
| 1225362726 | Witham and Associates, Inc. | Psychiatry & Neurology | 7575 Northcliff Ave, Suite 201, Brooklyn, OH 44144-3267 | 2009-09-30 |
| 1639300015 | Spectrum Diagnostic Imaging of Ohio LLC | Radiology | 7575 Northcliff Ave, Suite 105, Brooklyn, OH 44144-3267 | 2009-08-03 |
| 1659571776 | Precision Orthopaedic Specailties, Inc. | Anesthesiology | 7575 Northcliff Ave, Suite 300, Brooklyn, OH 44144-3267 | 2007-07-18 |
| 1427107713 | Kristen Kay Holderman | Nurse Practitioner | 7575 Northcliff Ave, Suite 400, Brooklyn, OH 44144-3267 | 2007-01-09 |
| 1255433371 | Michele Moore | Family Medicine | 7575 Northcliff Ave, Suite 305, Brooklyn, OH 44144-3267 | 2006-09-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023531399 | Jacques Pollard | Home Health | 4228 West 58 Street, Cleveland, OH 44144 | 2017-07-19 |
| 1992248264 | Navjot Mahal | Pharmacist | 4728 Springwood Dr, Brooklyn, OH 44144 | 2016-11-18 |
| 1033503800 | Adam Grassi | Specialist/Technologist | 5605 Behrwald Avenue, Cleveland, OH 44144 | 2015-03-19 |
| 1033529342 | Chad Wilson | Psychologist | 9200 Biddulph Road, Brooklyn, OH 44144 | 2014-05-08 |
| 1508103631 | Hearty Hearts Home Health, LLC. | Home Health | 4161 Ridge Road, Cleveland, OH 44144 | 2013-01-09 |
| 1821206160 | Theresa Mcquinta Glynn | Licensed Practical Nurse | 4519 Wichita, Cleveland, OH 44144 | 2007-05-18 |
| 1821156696 | Anthony James Wyrwas | Chiropractor | 7575 Northcliff Avenue, Suite 405, Brooklyn, OH 44144 | 2006-12-05 |
| 1891271813 | Steven V Kozmary Md LLC | Clinic/Center | 7575 Northcliff Ave Ste 200, Brooklyn, OH 44144 | 2018-07-12 |
| 1881047306 | Christina Ferraro | Nurse Practitioner | 9500 Euclid Ave, R32, Cleveland, OH 44144 | 2016-07-20 |
| 1730743014 | Dialene R Haines | Contractor | 4200 Westbrook Dr Apt 110, Brooklyn, OH 44144-1201 | 2019-04-23 |
| Find all providers in zip 44144 | ||||
| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
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| 1265060289 | Biotia, Inc. | Clinical Medical Laboratory | 140 58th St., Building A Suite 8j, Brooklyn, NY 11220-1122 | 2020-03-27 |
| 1316597958 | Labq Clinical Diagnostics LLC Dba Labq Diagnostics | Clinical Medical Laboratory | 140 58th St. Bldg A, Suite 3l, Brooklyn, NY 11220 | 2019-09-16 |
| 1699279570 | W. A. Foote Memorial Hospital, Inc | Clinical Medical Laboratory | 153 Wamplers Lake Rd, Brooklyn, MI 49230-9585 | 2018-03-23 |
| 1467805952 | Diagnostics In Totality Inc | Clinical Medical Laboratory | 816 45th St, Brooklyn, NY 11220-1611 | 2016-07-20 |
| 1932589041 | L&m Lab Corp | Clinical Medical Laboratory | 2960 Ocean Ave Fl 5, Brooklyn, NY 11235-3202 | 2015-06-03 |
| 1245628163 | Park Vascular LLC | Clinical Medical Laboratory | 990 E 23rd St, Brooklyn, NY 11210-3622 | 2014-12-30 |
| 1417355678 | Atlantic Diagnostics LLC | Clinical Medical Laboratory | 1642 W 9th St, Brooklyn, NY 11223-1247 | 2014-12-19 |
| 1588093165 | Shiel Holdings LLC | Clinical Medical Laboratory | 63 Flushing Avenue, Unit 336, 2nd Floor, Brooklyn, NY 11205-1083 | 2013-11-05 |
| Find all providers in BROOKLYN | ||||
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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.