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Contact Information

PROVIDERGENIX LLC
3100 E 45TH ST STE 234
CLEVELAND, OH44127-1091
 Phone: 419-406-0067
 Fax: 866-309-3044
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Primary Care

363LP2300X 50 Nurse Practitioner
 

Addiction (Substance Use Disorder)

163WA0400X
 

Addiction Psychiatry

2084P0802X 86 Physician/Neuropsychiatry
 

Family Medicine

207Q00000X 08 Physician/Family Practice
 

General Practice

163WG0000X
 

Home Health

163WH0200X
 

Infusion Therapy

163WI0500X
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Physician Assistant

363A00000X 97 Physician Assistant
 

Psychiatric/Mental Health

163WP0808X
 

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Registered Nurse

163W00000X
Indicates primary specialty

NPI Profile & details for PROVIDERGENIX LLC

NPI Number 1194327098
LBN Legal business name PROVIDERGENIX LLC
Authorized official THOMAS RUSSELL - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 11/15/2020
Last updated 11/15/2020 - About 6 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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