DR. ANGELA M BENNETT (NPI# 1861495236) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861495236 |
| Entity Type | Individual |
| Full Name | DR. ANGELA M BENNETT |
| Credential | M.D. |
| Practice Address |
11201 Shaker Blvd Suite 102a Cleveland OH 44104 |
| Mailing Address |
Po Box 932127 Cleveland OH 44193-0001 |
| Practice Telephone | 2167216900 |
| Practice Fax Number | 2163687905 |
| Mailing Telephone | 2164722730 |
| Mailing Fax Number | 2164722740 |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2011-09-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 35-088523 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2719071 | 05 | |
| OH | MEDICARE PTAN | 4203042 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225675770 | Angela Senaida Bennett | Behavior Technician | 1118 Hawaii Ave Apt A, Alamogordo, NM 88310-6441 | 2019-12-03 |
| 1912423518 | Angela Bennett | Licensed Practical Nurse | 4647 Lowell Ave Ne, Keizer, OR 97303-3842 | 2017-08-16 |
| 1144525098 | Angela Annett Bennett | Counselor | 716 Fancy Bluff Rd, Brunswick, GA 31523-6321 | 2011-01-24 |
| 1841513421 | Angela A. Bennett | Pediatrics | 8016 Colonial Road, Brooklyn, NY 11209-3520 | 2010-03-10 |
| 1730359142 | Angela Dawn Bennett | Pharmacist | 20 Industrial Drive, Dubois, PA 15801 | 2008-03-03 |
| 1720292527 | Angela Anita Bennett | Licensed Vocational Nurse | 4040 Selfridge Pkwy, Highland Hills, OH 44122-7021 | 2007-05-10 |
| 1770146136 | Angela Bennett | Counselor | 3040 Holcomb Bridge Rd, Norcross, GA 30071-1377 | 2019-04-20 |
| 1083152367 | Angela Bennett | Pediatrics | 500 Osborne Rd Ne, Suite 215, Fridley, MN 55432-2765 | 2017-02-07 |
| 1699129726 | Angela Bennett | Physical Therapy Assistant | 14809 W 95th St, Lenexa, KS 66215-5220 | 2016-04-14 |
| 1003255027 | Angela Lilly Bennett | Speech-Language Pathologist | 700b Cromwell Dr, Greenville, NC 27858-5852 | 2013-06-24 |
| Street Address |
11201 SHAKER BLVD SUITE 102A |
| City | CLEVELAND |
| State | OH |
| Zip Code | 44104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1790179992 | Professional Dental Alliance | Dentist | 11201 Shaker Blvd, 136, Cleveland, OH 44104-3869 | 2015-03-25 |
| 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 | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417577537 | Eduardo Trevino | Family Medicine | 3009 Midfield Cir Se, Cleveland, TN 37323-0554 | 2020-04-18 |
| 1518429240 | Care Alliance | Family Medicine | 4050 Superior Ave Fl 3, Cleveland, OH 44103-1128 | 2019-04-02 |
| 1659808236 | Tara K Iyer | Family Medicine | Women's Health Institute 9500 Euclid Ave A81, Cleveland, OH 44195-0001 | 2017-05-15 |
| 1972958072 | Matthew Novin | Family Medicine | 15105 St Clair Ave, Cleveland, OH 44110-1111 | 2016-04-27 |
| 1235519166 | Michelle Caster | Family Medicine | 11100 Euclid Ave # B200, Cleveland, OH 44106 | 2015-06-05 |
| 1437545720 | Keisha Danielle Sullivan | Family Medicine | 11100 Euclid Ave Fl Bolwell6, Cleveland, OH 44106 | 2015-04-13 |
| 1356747679 | Rmi Holding Corporation, Inc | Family Medicine | 3854 Candies Creek Ln Nw, Cleveland, TN 37312-1863 | 2014-11-13 |
| 1326450123 | Anna Camille Moreno | Family Medicine | 9500 Euclid Ave # A1-854, Cleveland, OH 44195-1101 | 2014-05-28 |
| 1568874816 | Garrett L Kirkpatrick | Family Medicine | The Cleveland Clinic Foundation 9500 Euclid Ave, Cleveland, OH 44195-4420 | 2014-05-21 |
| 1104250448 | Aaron Doss Samuel | Family Medicine | 3178 Chestnut Cir Nw, Cleveland, TN 37312-2137 | 2013-08-22 |
| 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.