MEDICARE: CLEVELAND CLINIC MERCY HOSPITAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1437085107
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLEVELAND CLINIC MERCY HOSPITAL

Provider Business Mailing Address
First Line	:	6801 BRECKSVILLE RD
Second Line	:	STE 20 ATTN DPC RK 2-7
City	:	INDEPENDENCE
State	:	OH
Zip	:	44131-5062
Country	:	US
Telephone Number	:	999-999-9999
Fax Number	:

Provider Business Practice Location Address
First Line	:	506 W MAIN ST
Second Line	:
City	:	LOUISVILLE
State	:	OH
Zip	:	44641-1310
Country	:	US
Telephone Number	:	330-489-1362
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE VP CHIEF FINANCE OFFICER
Name	:	DENNIS LEE LARAWAY
Credential	:
Telephone Number	:	216-445-1343

Provider Enumeration Date	:	06/22/2026
Last Update Date	:	06/22/2026

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