NPIMap

Organization Active NPI

Jubilee Healthcare, LLC

  • Durable Medical Equipment & Medical Supplies
  • Chardon, OH
National Provider Identifier
1093206138
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
JUBILEE HEALTHCARE, LLC
Practice address
13170 Ravenna Rd Ste 200
Chardon, OH 44024-7022
Phone
(844) 542-6363
Fax
(216) 455-1810
NPI assigned
May 24, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Authorized official

Name
Kelly A Mowrer
Title
Credentialing
Phone
(440) 895-5056

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

13170 Ravenna Rd Ste 200
Chardon, OH 44024-7022

Mailing address

24651 Center Ridge Rd Ste 350
Westlake, OH 44145-5627
Phone (440) 895-5056

Other identifiers 1

IdentifierTypeStateIssuer
0192836MedicaidOH

Other names 1

  • NorthShore Healthcare Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Jubilee Healthcare LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1527120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1093206138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24651 CENTER RIDGE RD STE 350",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441455627",
            "telephone_number": "440-895-5056",
            "fax_number": "440-895-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13170 RAVENNA RD STE 200",
            "city": "CHARDON",
            "state": "OH",
            "postal_code": "440247022",
            "telephone_number": "844-542-6363",
            "fax_number": "216-455-1810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUBILEE HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-24",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "MOWRER",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "440-895-5056"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0192836",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NorthShore Healthcare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NorthShore Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chardon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.