KATHLEEN M FAGAN (NPI# 1528005543) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528005543 |
| Entity Type | Individual |
| Full Name | KATHLEEN M FAGAN |
| Credential | MD |
| Practice Address |
11100 Euclid Avenue Cleveland OH 44106 |
| Mailing Address |
3605 Warrensville Ctr Rd Msc9152 Shaker Hts OH 44122 |
| Practice Telephone | 2168447700 |
| Practice Fax Number | 2162866299 |
| Mailing Telephone | 2162866299 |
| Mailing Fax Number | 2162866341 |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2008-06-12 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2083P0500X |
Preventive Medicine Specialization: Preventive Medicine/Occupational Environmental Medicine |
35051175 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | UNISON | 000000221255 | 01 |
| OH | BCMH | 0607641 | 01 |
| OH | 0607641 | 05 | |
| OH | AETNA | 4052254 | 01 |
| OH | ANTHEM | 000000525944 | 01 |
| OH | BUCKEYE | 745904 | 01 |
| OH | WELLCARE | 363514 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225431232 | Kathleen Fagan | Occupational Therapist | 54 Bay State Ave, Somerville, MA 02144-2134 | 2014-10-03 |
| 1881041572 | Kathleen Ann Fagan | Registered Nurse | 7500 Auburn Rd, Concord Township, OH 44077-9602 | 2016-05-23 |
| 1386974517 | Kathleen Anne Fagan | Nurse Practitioner | 241 Moore St, Hackensack, NJ 07601-7533 | 2010-01-11 |
| Street Address |
11100 EUCLID AVENUE |
| City | CLEVELAND |
| State | OH |
| Zip Code | 44106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487659009 | Richard Josephson | Internal Medicine | 11100 Euclid Avenue, Cleveland, OH 44106 | 2005-06-20 |
| 1538768270 | Rohit Kesarwani | Neurological Surgery | 11100 Euclid Avenue, University Hospitals Cleveland Medical Center, Departme, Cleveland, OH 44106 | 2020-10-23 |
| 1720609449 | Soheil Hany El-azzouni | Student in an Organized Health Care Education/Training Program | 11100 Euclid Avenue, Cleveland, OH 44106 | 2020-05-05 |
| 1548895204 | Jennifer Gardner | Nurse Practitioner | 11100 Euclid Avenue, Mather Suite 1704, Cleveland, OH 44106 | 2020-03-03 |
| 1811539398 | Erin Collard | Nurse Practitioner | 11100 Euclid Avenue, Seidman Cancer Center 4th Floor, Berger Office, Cleveland, OH 44106 | 2019-10-16 |
| 1245795236 | Olumide Babatope Ogunwumi | Physician Assistant | 11100 Euclid Avenue, Room 3001, Lerner Tower 3, Cleveland, OH 44106 | 2019-02-05 |
| 1992276661 | Catherine Lee | Clinical Neuropsychologist | 11100 Euclid Avenue, Department of Neurology, Cleveland, OH 44106 | 2018-12-06 |
| 1396258273 | Brittany J Smith | Registered Nurse | 11100 Euclid Avenue, Cleveland, OH 44106 | 2017-11-14 |
| 1457887994 | Akisha Glasgow | Student in an Organized Health Care Education/Training Program | 11100 Euclid Avenue, University Hospitals Cleveland Medical Center, Cleveland, OH 44106 | 2017-05-03 |
| 1952835068 | Morgan Brynn Weber | Student in an Organized Health Care Education/Training Program | 11100 Euclid Avenue, University Hospitals Cleveland Medical Center, Cleveland, OH 44106 | 2017-04-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295347706 | Adeeb Oweidat | Anesthesiology | 1999 Circle Drive Centric, Apartment 417, Cleveland, OH 44106 | 2020-08-18 |
| 1104434240 | Bradly Miner | Student in an Organized Health Care Education/Training Program | Health Education Campus, 9501 Euclid Ave, Cleveland, OH 44106 | 2020-07-15 |
| 1306466974 | Ho Jun Lee | Student in an Organized Health Care Education/Training Program | 11100 Euclid Ave University Hospitals Cleveland Medical, Cleveland, OH 44106 | 2020-04-23 |
| 1528687837 | Shaleeka Cornelius | Student in an Organized Health Care Education/Training Program | 11100 Euclid Avenue Han 5042, University Hospitals Cleveland Medical Center, Cleveland, OH 44106 | 2020-04-16 |
| 1598393175 | Mikdat Ulas | Student in an Organized Health Care Education/Training Program | 111000 Euclid Avenue, Cleveland, OH 44106 | 2020-03-30 |
| 1790335651 | Michelle Clark | Home Health Aide | 1794 E 87th St, Cleveland, OH 44106 | 2019-09-12 |
| 1881246783 | Oziel Valdez Sanchez | Student in an Organized Health Care Education/Training Program | 11900 Euclid Ave, Cleveland, OH 44106 | 2019-07-10 |
| 1487216842 | Betina Griens Porto | Dentist | 9601 Chester Avenue, Case Western Reserve School of Dental Medicine, Cleveland, OH 44106 | 2019-07-05 |
| 1407417140 | Rebecca Petts | Dentist | 9601 Chester Ave, Cleveland, OH 44106 | 2019-06-24 |
| 1023677259 | Moeen Al Weshah | Student in an Organized Health Care Education/Training Program | 9601 Chester Ave # 239j3, Cleveland, OH 44106 | 2019-06-11 |
| Find all providers in zip 44106 | ||||
| Taxonomy Code | 2083P0500X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Preventive Medicine/Occupational Environmental Medicine |
| A preventive medicine physician who specializes in preventive medicine/occupational-environmental medicine, which is focused on protecting the population from occupational and environmental conditions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356331789 | Patrick G Bray | Preventive Medicine | 2522 E 22nd St, Svch Occupational Medicine, Cleveland, OH 44115-3204 | 2005-10-26 |
| 1588615652 | Archana A Gorty | Preventive Medicine | 9500 Euclid Ave, Wl10, Cleveland, OH 44195-0001 | 2006-05-13 |
| 1972593309 | Daniel Y Ryu | Preventive Medicine | 2322 E 22nd St, Svch Occupational Medicine, Cleveland, OH 44115-3176 | 2005-10-26 |
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|---|---|---|---|---|
| 1780295386 | Healthstat Inc Huhtamaki New Vienna | Preventive Medicine | 5566 New Vienna Rd, New Vienna, OH 45159-9533 | 2020-08-17 |
| 1679101125 | Healthstat Onsite Clinic Vertiv Ironton | Preventive Medicine | 3040 S 9th St, Ironton, OH 45638-2895 | 2020-03-31 |
| 1760010219 | Healthstat Onsite Clinic Vertiv Dearborne | Preventive Medicine | 1050 Dearborn Dr, Columbus, OH 43085-1544 | 2020-03-31 |
| 1033747589 | Healthstat Onsite Clinic Vertiv Delaware | Preventive Medicine | 975 Pittsburgh Dr, Delaware, OH 43015-2858 | 2020-03-31 |
| 1538716790 | Healthstat Onsite Clinic Goodyear Icm | Preventive Medicine | 1367 Techway Drive, Akron, OH 44316 | 2019-08-22 |
| 1336796911 | Healthstat Onsite Clinic Goodyear Akron | Preventive Medicine | 200 E Innovation Way Ste 300, Akron, OH 44316-0001 | 2019-08-20 |
| 1477058576 | Healthstat Onsite Affinion Group | Preventive Medicine | 300 W Schrock Rd, Westerville, OH 43081-1189 | 2018-03-29 |
| 1568979045 | Healthstat Onsiet Clinic Nk Parts | Preventive Medicine | 800 S Kuther Rd, Sidney, OH 45365 | 2018-01-05 |
| 1346693876 | Healthstat Onsite Clinic Amsted Gw Groveport | Preventive Medicine | 3900 Bixby Rd, Groveport, OH 43125-9510 | 2016-07-20 |
| 1427309137 | Leslie M. Yee | Preventive Medicine | 4139 Malaer Dr, Cincinnati, OH 45241-6623 | 2012-09-21 |
| Find all providers with the same taxonomy | ||||
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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.