Individual provider Active NPI

Jennifer J.R. Loomis, AA-C

  • Anesthesiologist Assistant
  • Willoughby, OH
National Provider Identifier
1104919604
Registry record updated Feb 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
67.000123 Issued in OH
Practice address
36000 Euclid Ave
Willoughby, OH 44094-4625
Phone
(440) 350-0832
Fax
(440) 354-7420
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 67.000123 OH Primary

Addresses

Primary practice location

36000 Euclid Ave
Willoughby, OH 44094-4625

Mailing address

7757 Auburn Rd Ste 15
Painesville, OH 44077-9604
Phone (440) 350-0832

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061113000408 OH Practitioner - Anesthesiology Assistant 5496753113 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohio Anesthesia Group, IncGroup PAC ID 9537222138, 130 clinicians

Practice addresses (Care Compare)

36000 Euclid Ave
Willoughby, OH 44094-4625
Phone (440) 350-0832

Merit-based Incentive Payment System (MIPS)

Final score
78.79 of 100Reported as group
Quality
71.01
Improvement activities
40
Cost
82.45

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
67.000123OHMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio Anesthesia Group, Inc CurrentSince Apr 17, 2020 Accepting new patients
Anesthesia Associates of Savannah ,PA Past Accepting new patients

Locations

1320 Timken Mercy Dr NW
Canton, OH 44708
Phone (330) 489-1000

7757 Auburn Rd
Ste 15
Concord Township, OH 44077
Phone (440) 709-9150

9485 Mentor Ave
Mentor on Lk, OH 44060
Phone (440) 205-5755

36000 Euclid Ave
Willoughby Hills, OH 44094
Phone (440) 375-8166

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582848000000",
    "number": "1104919604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7757 AUBURN RD STE 15",
            "city": "PAINESVILLE",
            "state": "OH",
            "postal_code": "440779604",
            "telephone_number": "440-350-0832",
            "fax_number": "440-354-7420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36000 EUCLID AVE",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440944625",
            "telephone_number": "440-350-0832",
            "fax_number": "440-354-7420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOOMIS",
        "first_name": "JENNIFER",
        "middle_name": "J.R.",
        "credential": "AA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2020-02-28",
        "certification_date": "2020-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "OH",
            "license": "67.000123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willoughby, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.