Individual provider Active NPI

John L. Pund, PA-C

  • Physician Assistant
  • Mayfield HTS, OH
National Provider Identifier
1023007580
Registry record updated Jul 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50-000409 Issued in OH
Practice address
6801 Mayfield Rd
Ste 450
Mayfield HTS, OH 44124-2270
Phone
(440) 312-3845
Fax
(440) 312-7171
NPI assigned
Oct 18, 2005
Last updated
Jul 30, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50-000409 OH Primary

Addresses

Primary practice location

6801 Mayfield Rd
Ste 450
Mayfield HTS, OH 44124-2270

Mailing address

6801 Mayfield Rd
Ste 450
Mayfield HTS, OH 44124-2270
Phone (440) 312-3845

Other identifiers 2

IdentifierTypeStateIssuer
P00204417OtherOHRAILROAD MEDICARE
000000336124OtherOHANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50-000409OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Clinic Physician Services Co. LLC Past Accepting new patients
The Cleveland Clinic Foundation Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438214400000",
    "number": "1023007580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 MAYFIELD RD",
            "address_2": "STE 450",
            "city": "MAYFIELD HTS",
            "state": "OH",
            "postal_code": "441242270",
            "telephone_number": "440-312-3845",
            "fax_number": "440-312-7171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 MAYFIELD RD",
            "address_2": "STE 450",
            "city": "MAYFIELD HTS",
            "state": "OH",
            "postal_code": "441242270",
            "telephone_number": "440-312-3845",
            "fax_number": "440-312-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUND",
        "first_name": "JOHN",
        "middle_name": "L.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2015-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50-000409",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00204417",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000336124",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayfield HTS, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.