NPI Code Detail JSON Logo

1619785698 NPI number — CLEVELAND GROVER OAKES JR.

NPI Number: 1619785698
Health Care Provider/Practitioner: CLEVELAND GROVER OAKES JR.

Information about “1619785698” NPI (CLEVELAND GROVER OAKES JR.) exists in 1619785698 in HTML format HTML  |  1619785698 in plain Text format TXT  |  1619785698 in PDF (Portable Document Format) PDF  |  1619785698 in an XML format XML  formats.

NPI Number : 1619785698 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1619785698",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "OAKES",
    "FirstName": "CLEVELAND",
    "MiddleName": "GROVER",
    "NamePrefix": null,
    "NameSuffix": "JR.",
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "422 MINNIEFORD AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BRONX",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "10464-1316",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "347-526-6807",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "422 MINNIEFORD AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BRONX",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "10464-1316",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "347-526-6807",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "12/23/2024",
    "LastUpdateDate": "05/08/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": "P133982",
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "171M00000X",
          "TaxonomyName": "Case Manager/Care Coordinator",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

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