BEVERLY A WISDOM


Address: 10701 East Blvd, Suite 1b 236, Cleveland, OH 44106-1702
Phone: 4192153171

BEVERLY A WISDOM (NPI# 1942208939) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1942208939
Entity Type Individual
Full Name BEVERLY A WISDOM
Credential PA
Practice Address 10701 East Blvd
Suite 1b 236
Cleveland
OH 44106-1702
Mailing Address 10701 Wade Park
Suite 1-b 236
Cleveland
OH 44106-1702
Practice Telephone 4192153171
Practice Fax Number 2162313411
Mailing Telephone 4192153171
Mailing Fax Number 2162313411
Enumeration Date 2005-07-13
Last Update Date 2020-06-29
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
50001450 OH Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 10701 EAST BLVD
SUITE 1B 236
City CLEVELAND
State OH
Zip Code 44106-1702

Providers in the same location

NPI Name Taxonomy Address Enumeration
1013517366 Michael Nielsen Recreational Therapist Assistant 10701 East Blvd, Cleveland, OH 44106-1702 2020-10-27
1063010692 Hailey L Thomas Dietitian, Registered 10701 East Blvd, Cleveland, OH 44106-1702 2020-10-15
1588262406 Kinxian Thach Registered Nurse 10701 East Blvd, Cleveland, OH 44106-1702 2020-10-13
1942817572 Robin Eminger Nurse Practitioner 10701 East Blvd, Cleveland, OH 44106-1702 2020-09-28
1396352076 Brittany B Boykin Respiratory Therapist, Registered 10701 East Blvd, Cleveland, OH 44106-1702 2020-09-28
1669086955 Colleen A Gepperth Nurse Practitioner 10701 East Blvd, Cleveland, OH 44106-1702 2020-09-03
1588277966 Tarah Midy Psychologist 10701 East Blvd, Cleveland, OH 44106-1702 2020-08-26
1710590062 Colleen Licursi Social Worker 10701 East Blvd, Cleveland, OH 44106-1702 2020-08-26
1952913873 Shivali Dyal Singh Pharmacist 10701 East Blvd, Cleveland, OH 44106 2020-08-21
1225640360 Kelsi Bobbitt Counselor 10701 East Blvd, Cleveland, OH 44106-1702 2020-08-19
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1295347706 Adeeb Oweidat Anesthesiology 1999 Circle Drive Centric, Apartment 417, Cleveland, OH 44106 2020-08-18
1104434240 Bradly Miner Student in an Organized Health Care Education/Training Program Health Education Campus, 9501 Euclid Ave, Cleveland, OH 44106 2020-07-15
1306466974 Ho Jun Lee Student in an Organized Health Care Education/Training Program 11100 Euclid Ave University Hospitals Cleveland Medical, Cleveland, OH 44106 2020-04-23
1528687837 Shaleeka Cornelius Student in an Organized Health Care Education/Training Program 11100 Euclid Avenue Han 5042, University Hospitals Cleveland Medical Center, Cleveland, OH 44106 2020-04-16
1598393175 Mikdat Ulas Student in an Organized Health Care Education/Training Program 111000 Euclid Avenue, Cleveland, OH 44106 2020-03-30
1790335651 Michelle Clark Home Health Aide 1794 E 87th St, Cleveland, OH 44106 2019-09-12
1881246783 Oziel Valdez Sanchez Student in an Organized Health Care Education/Training Program 11900 Euclid Ave, Cleveland, OH 44106 2019-07-10
1487216842 Betina Griens Porto Dentist 9601 Chester Avenue, Case Western Reserve School of Dental Medicine, Cleveland, OH 44106 2019-07-05
1407417140 Rebecca Petts Dentist 9601 Chester Ave, Cleveland, OH 44106 2019-06-24
1023677259 Moeen Al Weshah Student in an Organized Health Care Education/Training Program 9601 Chester Ave # 239j3, Cleveland, OH 44106 2019-06-11
Find all providers in zip 44106

Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1679122394 Mariah Bower Physician Assistant 2725 Hampshire Rd Apt 3, Cleveland, OH 44106-2570 2019-09-05
1205319753 Jennifer Lee Seegichetla Physician Assistant 11100 Euclid Ave # Seidman7, Cleveland, OH 44106-1716 2018-09-11
1396291019 Kaitlin Elizabeth Ruszkowski Physician Assistant 2049 E 100th St Cleveland Clinic, Cleveland, OH 44195 2016-09-01
1528411493 Kayla Losco Physician Assistant 18101 Lorain Avenue-cleveland Clinic-fairview Hospital, Emergency Services, Cleveland, OH 44111-5612 2016-07-15
1356705719 Alison Rae Dushac Physician Assistant Cleveland Clinic Emergency Department, 9105 Cedar Avenue, Cleveland, OH 44195-0001 2016-04-11
1518330687 Erica Paul Physician Assistant 9105 Cedar Ave, E Building, Cleveland, OH 44195-0001 2015-11-11
1588961189 Jennifer Lynn Tresler Physician Assistant 1700 E 13th St Apt 14h, Cleveland, OH 44114-3219 2011-02-16
1417194978 Bolivar Emergency Group LLC Physician Assistant 901 Hwy 8 East Sunflower Rd, Cleveland, MS 38732 2009-01-20
1295911279 Dennis Albert Frinzl Physician Assistant 4450 Saint Clair Ave, Cleveland, OH 44103-1126 2008-01-21
1023207891 Amy M. Drab Physician Assistant 9500 Euclid Ave # Q2-1, Cleveland, OH 44195-8485 2007-10-17
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Competitor

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City CLEVELAND
Zip Code 44106

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Dataset Information

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.

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