Philip Coverdale

Uh Conneaut Medical Center NPI1740225911

Summary

Provider Details

NPI Number 1740225911
Provider Name Philip Coverdale
Credential MD
Specialization
Medical School Name Clvlnd Clinic Lerner College Of Med Of Case Wstn Rsv University
Graduation Year 1982
Gender M
Entity Type Individual
PAC ID by PECOS 4486605722
Professional Enrollment ID I20050203000907
Enumeration Date 06/19/2006
Last Update Date 07/08/2007

Contact Details

Business Practice address 18697 BAGLEY RD, Middleburg Heights,
44130-3417 Ohio View on Google Map
Business Practice phone 440-816-8000
Business Practice fax
Mailing address 24049 SHAKER BLVD, Shaker Heights,
44122-2684 Ohio View on Google Map
Other phone
Other fax
Email Address shannonfig@domain.com Reval Email Address
Incorrect information? Update the NPI Details for Philip Coverdale MD Update NPI

Payments

Total Payment Worth

$11.37
from 1 payments in the last 6 years

Total Cash or Cash Equivalent

$0.00
from 0 payments in the last 6 years

Total In-kind Items & Services

$11.37
from 1 payments in the last 6 years

Hospital Affilitation

Uh Conneaut Medical Center in Middleburg Heights

Middleburg Heights, Ohio

University Hospitals Geneva Medical Center

Uh Regional Hospitals

University Hospitals Of Cleveland

Education & Training

Clvlnd Clinic Lerner College Of Med Of Case Wstn Rsv University

1982

Group Affiliation

Organization Name PECOS PAC ID Members
University Emergency Specialists Llc 4587807854 15
Ues Geneva Llc 4789827064 15
4M Emergency Systems Llc 7719882182 20
Ues Geauga, Llc 6406876002 21
University Hospitals Urgent Care, Llc 3971985607 42
Emergency Professional Services, Inc. 7214832435 89

Public Reporting for Performance Scores

More Details

Final MIPS Score

83.25 out of 100

Score Breakdown

Quality Category Score 73.39
PI Category Score 0

 

IA Category Score 40
Cost Category Score 0
Total Patients: 81
Source of Scores: group
Newsletter for Healthcare Professionals

Provider Taxonomy Details

Primary Taxonomy
Taxonomy
License No.
35048557C (Ohio)

Reference NPI Information (as per NPPES NPI Record)

Field Name Field Value
NPI 1740225911
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Entity Type Individual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor Y
Indicate whether provider is a sole proprietor.
  • A sole proprietor is the sole (the only) owner of a business that is not incorporated; that unincorporated business is a sole proprietorship.
  • In a sole proprietorship, the sole proprietor owns all of the assets of the business and is solely liable for all of the debts of the business.
  • There is no difference between a sole proprietorship and a sole proprietor; they are legally a single entity: an individual.
  • In terms of NPI assignment, a sole proprietor is an Entity type 1 (Individual) and is eligible for only one NPI (the sole proprietorship business is not eligible for its own NPI).
  • As an individual, a sole proprietorship cannot be a subpart and cannot have subparts. (See NPI Final Rule for information about subparts.)
  • A sole proprietorship may or may not have employees.
  • Often, the IRS assigns an EIN to a sole proprietorship in order to protect the sole proprietor's SSN from disclosure in claims or on W-2s. NPPES does not capture a sole proprietorship's EIN.
  • Many types of health care providers could be sole proprietorships (for example, group practices, pharmacies, home health agencies).
Provider Last Name (Legal Name) Coverdale
The last name of the provider (if an individual). If the provider is an individual, this is the legal name. This name must match the name on file with the Social Security Administration (SSA). In addition, the date of birth must match that on file with SSA. (First and last names are required for initial applications.) The First, Middle, Last and Credential(s) fields allow the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Name Philip
The first name of the provider, if the provider is an individual.
Provider Credential Text MD
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider First Line Business Mailing Address 24049 SHAKER BLVD
The first line mailing address of the provider being identified. This data element may contain the same information as ''Provider first line location address''.
Provider Business Mailing Address City Name Shaker Heights
The City name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address City name''.
Provider Business Mailing Address State Name Ohio
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address State name''.
Provider Business Mailing Address Postal Code 44122-2684
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ''Provider location address postal code''.
Provider Business Mailing Address Country Code US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address country code''.
Provider First Line Business Practice Location Address 18697 BAGLEY RD
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name Middleburg Heights
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name Ohio
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code 44130-3417
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number 440-816-8000
The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date 06/19/2006
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date 07/08/2007
The date that a record was last updated or changed.
Provider Gender Code M
The code designating the provider's gender if the provider is a person.
Provider Gender Male
The provider's gender if the provider is a person.
Healthcare Provider Taxonomy Code #1 207P00000X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1 An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
Healthcare Provider Taxonomy #1
Provider License Number 1 35048557C
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1 OH
Provider License Number State Code #1
Healthcare Provider Primary Taxonomy Switch 1 Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.