Individual provider Active NPI

Jane Schaefer, N.P.

  • Adult Health Nurse Practitioner
  • Independence, OH
National Provider Identifier
1124038385
Registry record updated Feb 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
COA 01288 Issued in OH
Practice address
6100 Rockside Woods Blvd N
Suite 425
Independence, OH 44131-2366
Phone
(216) 643-2780
NPI assigned
Aug 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 019744021 OH
Adult Health Nurse Practitioner 363LA2200X COA 01288 OH Primary

Addresses

Primary practice location

6100 Rockside Woods Blvd N
Suite 425
Independence, OH 44131-2366

Mailing address

308 N Pleasant St
Oberlin, OH 44074-1114

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
019744021OHMDLicensed Practical Nurse
COA 01288OHMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360627200000",
    "number": "1124038385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 N PLEASANT ST",
            "city": "OBERLIN",
            "state": "OH",
            "postal_code": "440741114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 ROCKSIDE WOODS BLVD N",
            "address_2": "SUITE 425",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441312366",
            "telephone_number": "216-643-2780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAEFER",
        "first_name": "JANE",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2013-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "019744021",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "COA 01288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2013; 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.