MEDICARE: THE LITTLE CLINIC OF OHIO LLC

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	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1427494749
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE LITTLE CLINIC OF OHIO LLC

Provider Business Mailing Address
First Line	:	PO BOX 932958
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44193-0028
Country	:	US
Telephone Number	:	615-425-4287
Fax Number	:

Provider Business Practice Location Address
First Line	:	5830 HARRISON AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45248
Country	:	US
Telephone Number	:	513-693-4035
Fax Number	:

Authorized Official
Title or Position	:	VP & GENERAL MANAGER
Name	:	THOMAS SHELLY
Credential	:
Telephone Number	:	615-425-4200

Provider Enumeration Date	:	05/14/2013
Last Update Date	:	10/22/2025

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