NPIMap

Organization Active NPI

Jubilee Healthcare, LLC

Doing business as North Shore Healthcare

  • Durable Medical Equipment & Medical Supplies
  • Avon Lake, OH
National Provider Identifier
1184148900
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
JUBILEE HEALTHCARE, LLC
Doing business as
North Shore Healthcare
Practice address
32730 Walker Rd Ste J
Avon Lake, OH 44012-4100
Phone
(440) 455-3080
Fax
(440) 653-9670
NPI assigned
Aug 2, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Sheila Tonn-Knopf
Title
Executive Director
Phone
(440) 315-8896

Specialties & licenses 1

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

Addresses

Primary practice location

32730 Walker Rd Ste J
Avon Lake, OH 44012-4100

Mailing address

32730 Walker Rd Ste J
Avon Lake, OH 44012-4100
Phone (440) 455-3080

Other identifiers 1

IdentifierTypeStateIssuer
0192836MedicaidOH

Other names 1

  • North Shore 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.

Locations

32730 Walker Rd
Ste J
Avon Lake, OH 44012
Phone (440) 455-3080

NPI Registry JSON

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

{
    "created_epoch": "1501632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1184148900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32730 WALKER RD STE J",
            "city": "AVON LAKE",
            "state": "OH",
            "postal_code": "440124100",
            "telephone_number": "440-455-3080",
            "fax_number": "440-653-9670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32730 WALKER RD STE J",
            "city": "AVON LAKE",
            "state": "OH",
            "postal_code": "440124100",
            "telephone_number": "440-455-3080",
            "fax_number": "440-653-9670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUBILEE HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-02",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "TONN-KNOPF",
        "authorized_official_first_name": "SHEILA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "440-315-8896"
    },
    "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": "North Shore Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Avon Lake, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.