OUTREACH PROFESSIONAL SERVICES INC (NPI# 1104008879) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104008879 |
| Entity Type | Organization |
| Organization Name | OUTREACH PROFESSIONAL SERVICES INC |
| Other Organization Name | CUYAHOGA PHYSICIAN NETWORK |
| Practice Address |
11201 Shaker Blvd Suite 102 Cleveland OH 44104 |
| Mailing Address |
26908 Detroit Rd Suite 301 Westlake OH 44145-2398 |
| Practice Telephone | 2167216900 |
| Practice Fax Number | 2163687905 |
| Mailing Telephone | 4406171823 |
| Mailing Fax Number | 4406170884 |
| Enumeration Date | 2007-12-04 |
| Last Update Date | 2010-01-12 |
| Authorized Official Name | MISTY A BLAYLOCK (CREDENTIALING COORDINATOR) |
| Authorized Official Telephone | 4408926406 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0251856 | 05 |
| Other Name | Type Code |
|---|---|
| Cuyahoga Physician Network | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033391792 | Outreach Professional Services Inc | Orthopaedic Surgery | 14601 Detroit Rd, Suite 640, Lakewood, OH 44107 | 2007-12-04 |
| 1184916033 | Outreach Professional Services Inc | Durable Medical Equipment & Medical Supplies | 6701 Rockside Rd, Suite 100, Independence, OH 44131-2358 | 2011-05-11 |
| 1053599209 | Outreach Professional Services Inc | Neurological Surgery | 5334 Meadow Lane Ct, Sheffield Village, OH 44035-1469 | 2008-02-08 |
| 1770765380 | Outreach Professional Services Inc | Orthopaedic Surgery | 33141 Bainbridge Rd, Solon, OH 44139 | 2007-12-05 |
| 1780866392 | Outreach Professional Services Inc | Internal Medicine | 2322 East 22nd St, Suite 200, Cleveland, OH 44115 | 2007-12-05 |
| 1356523963 | Outreach Professional Services Inc | Advanced Practice Midwife | 29325 Health Campus Dr, Suite 1, Westlake, OH 44145 | 2007-12-05 |
| 1326220930 | Outreach Professional Services Inc | Anesthesiology | 2351 East 22nd St, Cleveland, OH 44115 | 2007-12-05 |
| 1952583627 | Outreach Professional Services Inc | Durable Medical Equipment & Medical Supplies | 6701 Rockside Rd, Suite 103, Independence, OH 44131-2358 | 2007-12-04 |
| 1396927067 | Outreach Professional Services Inc | Surgery | 4415 Euclid Ave, Suite 110, Cleveland, OH 44103 | 2007-12-04 |
| 1780866467 | Outreach Professional Services Inc | Internal Medicine | 2322 East 22nd St, Suite 207, Cleveland, PA 44145 | 2007-12-04 |
| Street Address |
11201 SHAKER BLVD SUITE 102 |
| City | CLEVELAND |
| State | OH |
| Zip Code | 44104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861495236 | Angela M Bennett | Family Medicine | 11201 Shaker Blvd, Suite 102a, Cleveland, OH 44104 | 2005-05-31 |
| 1659997492 | Jalysa Blake | Case Manager/Care Coordinator | 11201 Shaker Blvd, Cleveland, OH 44104-3869 | 2020-06-17 |
| 1417572348 | Camille Horton | Case Manager/Care Coordinator | 11201 Shaker Blvd, Cleveland, OH 44104-3869 | 2020-06-16 |
| 1073136024 | Carol Range | Case Manager/Care Coordinator | 11201 Shaker Blvd, Cleveland, OH 44104-3869 | 2020-05-26 |
| 1265052179 | Brieana Wilson | Case Manager/Care Coordinator | 11201 Shaker Blvd, Cleveland, OH 44104-3869 | 2020-04-21 |
| 1851802615 | Aditi Parikh | Dentist | 11201 Shaker Blvd, Cleveland, OH 44104-3869 | 2017-10-19 |
| 1932610698 | Quentin Joh-douglas Montgomery | Dentist | 11201 Shaker Blvd, Cleveland, OH 44104 | 2017-10-19 |
| 1972952554 | Cleveland Accident Rehab, LLC | Chiropractor | 11201 Shaker Blvd, 322, Cleveland, OH 44104 | 2016-06-06 |
| 1003276106 | Cleveland Dental Institute LLC | Clinic/Center | 11201 Shaker Blvd, Cleveland, OH 44104-3869 | 2016-03-02 |
| 1336527340 | Lawrence Rossoff | Dentist | 11201 Shaker Blvd, #136, Cleveland, OH 44104-3869 | 2015-05-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619510419 | Gwen Burtin | Technician | 9908 Kennedy Ave, Cleveland, OH 44104 | 2019-10-24 |
| 1215422001 | Julia Shneyderman | Dentist | 11202 Shaker Blvd Ste 136, Cleveland, OH 44104 | 2018-06-25 |
| 1477058527 | Kwananda A Plato | Technician | 9717 Elwell Ave., Cleveland, OH 44104 | 2018-03-29 |
| 1073035887 | Tia Marie Heard | Home Health | 4591 Quincy Avenue Building Q, Cleveland, OH 44104 | 2017-07-13 |
| 1407306608 | Shelby Mcquiller | Social Worker | 2632 E 115th St, Cleveland, OH 44104 | 2016-10-11 |
| 1568852390 | Cleveland Arts & Social Sciences Academy | Psychologist | 10701 Shaker Blvd, Cleveland, OH 44104 | 2015-02-02 |
| 1164827705 | Eboni Danyale Jordan | Licensed Practical Nurse | 3143 East 99th, Cleveland, OH 44104 | 2014-10-24 |
| 1902224157 | Woodland Academy, Inc. | Local Education Agency (LEA) | 10615 Lamontier Blvd., Cleveland, OH 44104 | 2014-04-04 |
| 1467793778 | Teresa M Evans-guyton | Nurse Practitioner | 11201 Shaker Blvd Ste 240, Cleveland, OH 44104 | 2013-03-12 |
| 1023387057 | Roslyn Jeanette Carter | Home Health Aide | 9423 Ramona Blvd, Cleveland, OH 44104 | 2011-12-20 |
| Find all providers in zip 44104 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
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| 1881236560 | Fivestars Onlinecare | Internal Medicine | 850 Euclid Aveneue, Suite 1022, Cleveland, OH 44114 | 2019-10-14 |
| 1982161527 | Lake Point Medical Group,llc | Internal Medicine | 1730 W 25th St Ste 2e, Cleveland, OH 44113-3108 | 2019-03-01 |
| 1780154914 | Syah, LLC | Internal Medicine | 142 Parkway Plaza, Cleveland, GA 30528 | 2018-11-30 |
| 1255818001 | Simrat Kaur | Internal Medicine | Cleveland Clinic Foundation 9500 Euclid Avenue/na- 23, Cleveland, OH 44195-0001 | 2018-07-24 |
| 1528553005 | Nazire Albayrak | Internal Medicine | Cleveland Clinic 9500 Euclid Avenue/na2-3, Cleveland, OH 44195-0001 | 2018-06-26 |
| 1770082471 | Cleveland Clinic Health Services Professional Association, Inc | Internal Medicine | 9500 Euclid Ave # Na4, Cleveland, OH 44195 | 2018-02-08 |
| 1528580511 | Randol Jamel Kennedy | Internal Medicine | 2351 East 22nd Street Suite 338 W, St. Vincent Charity Medical Center, Cleveland, OH 44115 | 2017-07-11 |
| 1669994935 | Ji Seok Park | Internal Medicine | 9500 Euclid Ave A51, Cleveland, OH 44193-1913 | 2017-07-08 |
| 1407376031 | Arunbabu Sankaranarayanan | Internal Medicine | 2351 E 22nd St # 342w, Cleveland, OH 44115-3111 | 2017-06-24 |
| 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.