Amaris Jean Aesthetics and Wellness LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

AMARIS JEAN AESTHETICS AND WELLNESS LLC

Doing business as

Amaris Jean Aesthetics and Wellness LLc

Practice address

4630 Richmond Rd Ste 198
Cleveland, OH 44128-5954

Phone

(216) 855-7775

Fax

(216) 245-6126

NPI assigned

Nov 17, 2022

Organization subpart

No

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

Authorized official

Name

Ketura Jackson, NURSE PRACTITIONERNPI 1821229378

Title

Aprn/CNP/Owner

Phone

(216) 855-7775

Specialties & licenses 8

Addresses

Other names 1

• Amaris Jean Aesthetics and Wellness LLc Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ketura L Jackson, RN

  • Family Nurse Practitioner
  • Cleveland, OH
  • NPI 1821229378
  NPD Authorized official

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

{
    "created_epoch": "1668643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668643200000",
    "number": "1043929078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13512 THORNHURST AVE",
            "city": "GARFIELD HTS",
            "state": "OH",
            "postal_code": "441056851",
            "telephone_number": "216-855-7775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4630 RICHMOND RD STE 198",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441285954",
            "telephone_number": "216-855-7775",
            "fax_number": "216-245-6126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMARIS JEAN AESTHETICS AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-17",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "KETURA",
        "authorized_official_title_or_position": "APRN/CNP/OWNER",
        "authorized_official_telephone_number": "216-855-7775",
        "authorized_official_credential": "NURSE PRACTITIONER"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Amaris Jean Aesthetics and Wellness LLc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ashwinraj Amalraj, CAA
• Isabella Amaniera
• Papimpa Amantea
• Brian Amaral
• Katherine Rose Amarell
• Sudha Rani Amarnath, M.D.
• Daniel Amat, MD
• Alexandria Amato, APRN-CNP
• Briana Amato, MSN, APRN, CNP-PC
• Christine Amato

• Clinic/Center in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2022; 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.