RIDGEPARK NURSE PRACTITIONERS LLC (NPI# 1528311198) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528311198 |
| Entity Type | Organization |
| Organization Name | RIDGEPARK NURSE PRACTITIONERS LLC |
| Practice Address |
7575 Northcliff Ave Suite 400 Brooklyn OH 44144-3267 |
| Practice Telephone | 2167498276 |
| Mailing Telephone | 2167498276 |
| Enumeration Date | 2012-10-19 |
| Last Update Date | 2013-02-15 |
| Authorized Official Name | CHARLES ROBERT KOEPKE (PRESIDENT) |
| Authorized Official Telephone | 2167498276 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | RIDGEPARK MEDICAL ASSOCIATES, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
7575 NORTHCLIFF AVE SUITE 400 |
| 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 |
| 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 |
| 1407865488 | Ridgepark Medical Associates, Inc. | Clinical Medical Laboratory | 7575 Northcliff Ave, Laboratory Suite 106, Brooklyn, OH 44144-3267 | 2006-08-07 |
| 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 | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962029009 | Sharon Wu | Nurse Practitioner | 2426 W 3rd St, Brooklyn, NY 11223-5930 | 2020-07-05 |
| 1619590486 | Jan Jeremiah | Nurse Practitioner | 3839 Flatlands Ave Ste 100, Brooklyn, NY 11234-3535 | 2020-05-27 |
| 1801425210 | Rehana Luana Lowtan | Nurse Practitioner | 3101 Avenue I Apt 6c, Brooklyn, NY 11210-3855 | 2020-04-07 |
| 1942839485 | Avril Staceyanne Robinson | Nurse Practitioner | 924 E 101st St, Brooklyn, NY 11236-2618 | 2020-04-06 |
| 1275175994 | Idy Liang | Nurse Practitioner | 773 54th St, Brooklyn, NY 11220-3202 | 2019-10-15 |
| 1316595564 | Danielle Sharaby-glasser | Nurse Practitioner | Franklin K Lane School Based Health Center, 999 Jamaica Avenue, Brooklyn, NY 11208 | 2019-08-30 |
| 1245793900 | Jennifer Peace Polatchek | Nurse Practitioner | 40 Ocean Pkwy Apt 1d, Brooklyn, NY 11218-1538 | 2019-04-10 |
| 1235615923 | Mellisa Georgette Porter | Nurse Practitioner | 1180 E 55th St, Brooklyn, NY 11234-2418 | 2018-07-16 |
| 1518459825 | Mengmin Liu | Nurse Practitioner | 566 60th St, Brooklyn, NY 11220 | 2018-06-01 |
| 1467963157 | Janiece Ann Francis | Nurse Practitioner | 881 E 54th St, Brooklyn, NY 11234-1210 | 2017-10-20 |
| Find all providers in BROOKLYN | ||||
Please comment or provide details below to improve the information on RIDGEPARK NURSE PRACTITIONERS LLC.
| 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.