EYEBONE, LLC (NPI# 1730409400) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730409400 |
| Entity Type | Organization |
| Organization Name | EYEBONE, LLC |
| Other Organization Name | CHARDON SURGERY CENTER |
| Practice Address |
150 Seventh Ave Chardon OH 44024-2908 |
| Practice Telephone | 4402852900 |
| Practice Fax Number | 4402862905 |
| Mailing Telephone | 4402852900 |
| Mailing Fax Number | 4402862905 |
| Enumeration Date | 2010-06-04 |
| Last Update Date | 2011-01-11 |
| Authorized Official Name | DR. AUGUSTINE JOHN KELLIS (PRESIDENT) |
| Authorized Official Telephone | 4402854999 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
0979AS | OH | Ambulatory Health Care Facilities |
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
PENDING | OH | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Chardon Surgery Center | Doing Business As Name - Organization |
| Street Address |
150 SEVENTH AVE |
| City | CHARDON |
| State | OH |
| Zip Code | 44024-2908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831190313 | Michael J Kellis | Internal Medicine | 150 Seventh Ave, Suite 200, Chardon, OH 44024-2908 | 2005-08-09 |
| 1588186720 | Melius Anesthesia LLC | Nurse Anesthetist, Certified Registered | 150 Seventh Ave, Chardon, OH 44024-2908 | 2017-07-10 |
| 1194043208 | Tamara Ann Smith | Phlebology | 150 Seventh Ave, Suite 210, Chardon, OH 44024-2908 | 2010-05-13 |
| 1396950184 | Gene Aidan Johnson | Ophthalmology | 150 Seventh Ave, Suite 100, Chardon, OH 44024-2908 | 2007-05-14 |
| 1578681458 | Robert G Chandler | Physical Therapist | 150 Seventh Ave, Suite 200, Chardon, OH 44024 | 2007-03-27 |
| 1427105113 | Heidi F. Baldwin | Nurse Anesthetist, Certified Registered | 150 Seventh Ave, Chardon, OH 44024-2908 | 2007-01-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992336770 | Amanda Nicole Nelson | Technician, Other | 133 Up Main St, Chardon, OH 44024 | 2020-01-30 |
| 1679067011 | Janai Marshae Seng | Dentist | 401 South Street #3a, Chardon, OH 44024 | 2018-06-19 |
| 1376036475 | Kasandra Leigh Chapman | Social Worker | 12941 Ravenna Road, Chardon, OH 44024 | 2018-06-13 |
| 1275068652 | Danielle Tilton | Nurse Practitioner | 531 Fifth Ave, Chardon, OH 44024 | 2017-04-24 |
| 1881057040 | Erin Marie Moore | Counselor | 203 Main St., Chardon, OH 44024 | 2016-04-04 |
| 1649689886 | Hope Anne Super | Speech-Language Pathologist | 100 7th Av Suite 255, Chardon, OH 44024 | 2014-08-12 |
| 1740600022 | Elisha Tzvi Fredman | Student in an Organized Health Care Education/Training Program | 13207 Chardon Road, Ravenna, OH 44024 | 2014-04-24 |
| 1083039309 | Jamie Delvecchio | Family Medicine | 150 7th Ave Ste 200, Chardon, OH 44024 | 2014-02-24 |
| 1174947212 | Frank Scarano | Psychologist | 470 Center Street, Chardon, OH 44024 | 2014-02-10 |
| 1659706497 | Jamie Henderson | Physical Therapy Assistant | 9348 South Brown Rd, Chardon, OH 44024 | 2013-09-12 |
| Find all providers in zip 44024 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
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|---|---|---|---|---|
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| 1851904445 | The Good Samaritan Hospital of Cincinnati, Ohio | Clinic/Center | 538 Oak St Ste 100, Cincinnati, OH 45219-2554 | 2020-08-25 |
| 1952912552 | The Surgery Center of North Central Ohio LLC | Clinic/Center | 1 Emerald Pkwy, Norwalk, OH 44857-2671 | 2020-08-17 |
| 1295344026 | West Chester Surgical Suites, LLC | Clinic/Center | 8742-8744 Union Centre Blvd, West Chester, OH 45069-4876 | 2020-07-28 |
| 1194341768 | Wellington Specialty Surgery Center, LLC | Clinic/Center | 4355 Ferguson Dr Ste 190, Cincinnati, OH 45245-5137 | 2020-06-19 |
| 1902431646 | Central Ohio Endoscopy Center, LLC | Clinic/Center | 430 Altair Pkwy Ste 120, Westerville, OH 43082-7647 | 2020-03-03 |
| 1568094399 | The Surgery Center of Southwest Ohio, LLC | Clinic/Center | 2210 Arbor Blvd Ste 100, Moraine, OH 45439-1506 | 2020-02-10 |
| 1013565175 | David B Schwartz Md, LLC | Clinic/Center | 2123 Auburn Ave Ste 320, Cincinnati, OH 45219-2906 | 2019-08-30 |
| 1801457478 | Dialysis Access Center, LLC | Clinic/Center | 8423 Market St Ste 210, Boardman, OH 44512-6778 | 2019-06-25 |
| 1750948873 | Erie Shores Surgery Center LLC | Clinic/Center | 2800 Hayes Ave Bldg E, Sandusky, OH 44870-7255 | 2019-05-23 |
| 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.