Active NPI
Jacqueline Prentis
- Physical Therapist
- Macedonia, OH
National Provider Identifier
1063837086
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT.014628
- Practice address
- 9120 N Bedford Rd
Macedonia, OH 44056-1208 - Phone
- (330) 592-1339
- NPI assigned
- Feb 27, 2014
- Last updated
- Feb 27, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT.014628 | OH | Primary |
Addresses
Primary practice location
9120 N Bedford Rd
Macedonia, OH 44056-1208
Mailing address
9120 N Bedford Rd
Macedonia, OH 44056-1208
Phone (330) 592-1339
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT.014628 | OH | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1393459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1393459200000",
"number": "1063837086",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9120 N BEDFORD RD",
"city": "MACEDONIA",
"state": "OH",
"postal_code": "440561208",
"telephone_number": "330-592-1339"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9120 N BEDFORD RD",
"city": "MACEDONIA",
"state": "OH",
"postal_code": "440561208",
"telephone_number": "330-592-1339"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRENTIS",
"first_name": "JACQUELINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-02-27",
"last_updated": "2014-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "PT.014628",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Macedonia, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.