Individual provider Active NPI

Molly Mae Jonna

  • Pediatrics Physician
  • Cleveland, OH
National Provider Identifier
1083032403
Registry record updated Jun 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35.131051 Issued in OH
Practice address
11100 Euclid Ave
University Hospitals Case Medical Center
Cleveland, OH 44106-1716
Phone
(216) 844-1171
NPI assigned
Apr 2, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 35.131051 OH Primary

Addresses

Primary practice location

11100 Euclid Ave
University Hospitals Case Medical Center
Cleveland, OH 44106-1716

Mailing address

891 E Exchange St
Akron, OH 44311-1059
Phone (330) 543-8004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180905001934 IL Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 7315217510 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Carle Health Care Incorporated CurrentSince Aug 7, 2018 Accepting new patients

Locations

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1396396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497484800000",
    "number": "1083032403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "891 E EXCHANGE ST",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443111059",
            "telephone_number": "330-543-8004",
            "fax_number": "330-543-3210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 EUCLID AVE",
            "address_2": "UNIVERSITY HOSPITALS CASE MEDICAL CENTER",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441061716",
            "telephone_number": "216-844-1171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONNA",
        "first_name": "MOLLY",
        "middle_name": "MAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-02",
        "last_updated": "2017-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.131051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.