MARY ELLEN CAMPOBASSO (NPI# 1871802587) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871802587 |
| Entity Type | Individual |
| Full Name | MARY ELLEN CAMPOBASSO |
| Credential | ACNS-BC |
| Practice Address |
18697 Bagley Rd Middleburg Heights OH 44130-3417 |
| Mailing Address |
30680 Bainbridge Rd Solon OH 44139-2282 |
| Practice Telephone | 4408168000 |
| Mailing Telephone | 4405425023 |
| Mailing Fax Number | 4405425029 |
| Enumeration Date | 2010-09-29 |
| Last Update Date | 2010-09-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SA2200X |
Clinical Nurse Specialist Specialization: Adult Health |
COA02675-NS | OH | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
18697 BAGLEY RD |
| City | MIDDLEBURG HEIGHTS |
| State | OH |
| Zip Code | 44130-3417 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316568124 | Laura Stasiak | Pharmacist | 18697 Bagley Rd, Middleburg Heights, OH 44130-3417 | 2020-05-04 |
| 1992326300 | Kyle Gustafson | Pharmacist | 18697 Bagley Rd, Middleburg Heights, OH 44130-3497 | 2020-04-27 |
| 1295365088 | Hannah Blackburn | Physical Therapist | 18697 Bagley Rd, Middleburg Heights, OH 44130-3417 | 2020-01-21 |
| 1861038077 | Rebecca Ann Pollack | Emergency Medicine | 18697 Bagley Rd, Middleburg Heights, OH 44130-3497 | 2019-11-22 |
| 1609422138 | Kali Potopsky | Physician Assistant | 18697 Bagley Rd, Middleburg Heights, OH 44130-3417 | 2019-08-12 |
| 1699335588 | James Miner | Anesthesiologist Assistant | 18697 Bagley Rd, Middleburg Heights, OH 44130-3417 | 2019-06-13 |
| 1871054080 | Mary Gulla | Physical Therapist | 18697 Bagley Rd, Middleburg Heights, OH 44130-3417 | 2019-03-29 |
| 1629537253 | David Brian Haberman | Physical Therapist | 18697 Bagley Rd, Middleburg Heights, OH 44130-3417 | 2019-03-13 |
| 1649737487 | Amanda Vitek | Nurse Practitioner | 18697 Bagley Rd, Middleburg Heights, OH 44130-3417 | 2019-02-28 |
| 1356815922 | Hni Medical Services of Ohio, LLC | Internal Medicine | 18697 Bagley Rd, Middleburg Heights, OH 44130-3417 | 2019-01-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912545427 | Northeast Care Center, Inc. | Intermediate Care Facility, Mentally Retarded | 19080 Bagley Road, Middleburg Hts., OH 44130 | 2019-12-16 |
| 1982189148 | Carl Steinhoff | Registered Nurse | 13766 Cherokee Trail, Middleburg Heights, OH 44130 | 2018-10-03 |
| 1649756321 | Beatrice Shepherd | Counselor | 5253 Hauserman Rd Apt 212, Parma, OH 44130 | 2018-07-16 |
| 1841705068 | New Heights Aba, LLC | Behavioral Analyst | 6908 Engle Rd Ste D, Middleburg Heights, OH 44130 | 2017-12-11 |
| 1275059842 | Tynisha Nicole Nation | Registered Nurse | 6431 Olde York, Parma Hts, OH 44130 | 2017-08-16 |
| 1609328558 | Lisa Wolanin | Physical Therapist | 186970bagley Road, Middleburg Hts, OH 44130 | 2016-10-26 |
| 1184074205 | Tanya Makowski | Nurse Practitioner | 7215 Old Oak Blvd Ste A420, Cleveland, OH 44130 | 2016-06-20 |
| 1093165706 | Dana Hyde | Dentist | 7528 Pearl Rd, Middleburg Heights, OH 44130 | 2016-06-14 |
| 1689046625 | Kimberly Ann Piro | Nurse Practitioner | 12240 Zona Ln, Parma, OH 44130 | 2015-10-29 |
| 1225400088 | Larrise Williford | Registered Nurse | 11491 Sharon Dr Apt C705, Parma, OH 44130 | 2015-10-20 |
| Find all providers in zip 44130 | ||||
| Taxonomy Code | 364SA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184243941 | Christina Canfield | Clinical Nurse Specialist | 9500 Euclid Ave # J6, Cleveland, OH 44195-0001 | 2020-04-13 |
| 1073040929 | Stacy L Burns | Clinical Nurse Specialist | 250 S Osborn Ave, Youngstown, OH 44509-2909 | 2017-05-22 |
| 1134655350 | Bindhu Sajay | Clinical Nurse Specialist | 45431 Isaac Dr, Beavercreek, OH 45431-3051 | 2017-05-08 |
| 1750828406 | Keith B Evans | Clinical Nurse Specialist | 12 Lincoln Dr, Shelby, OH 44875-1482 | 2017-01-19 |
| 1760839070 | Deanna Petsas | Clinical Nurse Specialist | 35157 Poplar St, North Ridgeville, OH 44039-1549 | 2016-05-17 |
| 1083087852 | Tracy A. Riley | Clinical Nurse Specialist | 2270 Mohler Dr Nw, North Canton, OH 44720-5736 | 2015-11-03 |
| 1639542574 | Althea Premraj | Clinical Nurse Specialist | 26 Keswick Dr, Hudson, OH 44236-3338 | 2015-10-31 |
| 1013392646 | Lydia Booher | Clinical Nurse Specialist | 2320 12th St Sw, Akron, OH 44314-2058 | 2015-07-24 |
| 1265813984 | Ronald Rock | Clinical Nurse Specialist | 9500 Euclid Ave # M2-105, Cleveland, OH 44195-0001 | 2015-06-18 |
| 1518387257 | Beth Canfield | Clinical Nurse Specialist | 6721 Idlelawn Ave Nw, Canal Fulton, OH 44614-9420 | 2014-04-21 |
| Find all providers with the same taxonomy | ||||
| City | MIDDLEBURG HEIGHTS |
| Zip Code | 44130 |
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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.