ST AUGUSTINE MANOR (NPI# 1033599105) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033599105 |
| Entity Type | Organization |
| Organization Name | ST AUGUSTINE MANOR |
| Other Organization Name | ST AUGUSTINE MANOR PROFESSIONAL SERVICES |
| Practice Address |
7801 Detroit Ave Cleveland OH 44102-2813 |
| Practice Telephone | 2166347400 |
| Practice Fax Number | 2166347483 |
| Mailing Telephone | 2166347400 |
| Mailing Fax Number | 2166347483 |
| Enumeration Date | 2015-06-04 |
| Last Update Date | 2015-06-04 |
| Authorized Official Name | MR. FRANCIS S HUBA (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 2166347555 |
| Is Organization Subpart | Y |
| Parent Organization Name | ST AUGUSTINE MANOR |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| ST AUGUSTINE MANOR PROFESSIONAL SERVICES | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376667014 | St Augustine Manor | Hospice Care, Community Based | 6707 State Rd, Parma, OH 44134-4517 | 2007-03-19 |
| 1396883591 | St Augustine Manor | Skilled Nursing Facility | 7801 Detroit Avenue, Cleveland, OH 44102 | 2007-02-01 |
| 1578644316 | St Augustine Manor | Home Health | 6707 State Road, Parma, OH 44134 | 2006-10-18 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ST AUGUSTINE MANOR, INC. | 800 Bayard St, New Iberia, LA 70560-5761 |
| Street Address |
7801 DETROIT AVE |
| City | CLEVELAND |
| State | OH |
| Zip Code | 44102-2813 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235128034 | St. Augustine Services Corp. | Skilled Nursing Facility | 7801 Detroit Ave, Cleveland, OH 44102-2813 | 2005-10-14 |
| 1891331757 | Alyssa Osysko | Nurse Practitioner | 7801 Detroit Ave, Cleveland, OH 44102-2813 | 2019-11-25 |
| 1154586287 | St Augustine Services Corp | Skilled Nursing Facility | 7801 Detroit Ave, Cleveland, OH 44102-2813 | 2008-07-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174138259 | Christian Bracero | Home Health Aide | 1285 W 91 St Upstairs, Cleveland, OH 44102 | 2020-09-15 |
| 1639702855 | Ohio Wellness Transit | Non-emergency Medical Transport (VAN) | 3295 W. 97th St, Cleveland, OH 44102 | 2020-02-17 |
| 1538655642 | Alayah Wypasek | Case Manager/Care Coordinator | 3201 West 73rd, Cleveland, OH 44102 | 2018-07-02 |
| 1811489826 | Kimberly Ann Leftridge | Home Health Aide | 2088 W. 95th, Down, Cleveland, OH 44102 | 2018-06-05 |
| 1407352800 | Peace By Piece Cleveland | Community/Behavioral Health | 10237 Berea Rd, Cleveland, OH 44102 | 2018-04-04 |
| 1285130922 | Ruthanne Gurcze | Counselor | 3201 W 73rd Street, Cleveland, OH 44102 | 2018-04-02 |
| 1619486297 | Kimberly Billue | Home Health Aide | 2205 W 106th Street, Lower, Cleveland, OH 44102 | 2017-09-26 |
| 1114446473 | Kalia Marie Woods | Student in an Organized Health Care Education/Training Program | 2045 W 95th St, Cleveland, OH 44102 | 2017-09-18 |
| 1255858437 | Michelle Leann Genet | Counselor | 10427 Detroit Avenue, Cleveland, OH 44102 | 2017-08-28 |
| 1770033136 | Village Preparatory School IIi | Psychologist | 2220 W. 93rd St., Cleveland, OH 44102 | 2016-10-10 |
| Find all providers in zip 44102 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629592407 | Halyna V. Sul | Nurse Practitioner | 6770 Mayfield Rd Ste 425, Cleveland, OH 44124-2299 | 2017-08-02 |
| 1326122698 | Denise Marie Kresevic | Nurse Practitioner | 10710 East Blvd, Cleveland, OH 44106 | 2006-10-24 |
| 1700495181 | Elizabeth Ann Courtney Ramnytz | Nurse Practitioner | 9500 Euclid Ave, Cleveland, OH 44195-0001 | 2020-07-30 |
| 1124655295 | Emily Bulow | Nurse Practitioner | 9500 Euclid Ave, Cleveland, OH 44195-0002 | 2020-03-26 |
| 1982230470 | Chelsea Zeigler | Nurse Practitioner | 9500 Euclid Ave, Cleveland, OH 44195-0001 | 2020-03-17 |
| 1164062790 | Akisha Rochelle Burge | Nurse Practitioner | 11100 Euclid Ave, Cleveland, OH 44106-1716 | 2020-01-11 |
| 1427692029 | Darya Rybalko | Nurse Practitioner | 9500 Euclid Ave, Cleveland, OH 44195-0001 | 2019-11-06 |
| 1578111696 | Amanda Dawn Bovee | Nurse Practitioner | 17876 Saint Clair Ave, Cleveland, OH 44110 | 2019-09-02 |
| 1932689718 | Keara E. Walsh | Nurse Practitioner | 2500 Metrohealth Dr, Cleveland, OH 44109-1900 | 2018-08-21 |
| 1477033918 | Susan Lacey Antonelli | Nurse Practitioner | 17876 Saint Clair Ave, Cleveland, OH 44110-2602 | 2018-08-15 |
| Find all providers in CLEVELAND | ||||
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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.