Organization Active NPI

Special Hands LLC

  • Surgery Physician
  • Warrensville Heights, OH
National Provider Identifier
1235474347
Registry record updated Nov 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
35057489 Issued in OH
Legal business name
SPECIAL HANDS LLC
Practice address
20050 Harvard Ave
Suite 205
Warrensville Heights, OH 44122-6816
Phone
(440) 953-1898
NPI assigned
Nov 29, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2012

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

Authorized official

Name
Carl E Jackson, M.D.NPI 1831208768
Title
Owner
Phone
(440) 953-1898

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 35057489 OH Primary

Addresses

Primary practice location

20050 Harvard Ave
Suite 205
Warrensville Heights, OH 44122-6816

Mailing address

PO Box 22958
Cleveland, OH 44122-0958
Phone (216) 595-9600

Other identifiers 1

IdentifierTypeStateIssuer
0881247MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130313000034 OH Part B Supplier - Clinic/Group Practice 1153576400 Receives reassigned benefits from 1 practitioner
Practice locations: Warrensville Heights, OH; Ravenna, OH; Painesville, OH; Mayfield Heights, OH; Bellevue, OH; East Liverpool, OH; Ashtabula, OH; Beavercreek, OH…

National Provider Directory

National Provider Directory
Tax ID family
Carl E Jackson MD Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1354147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354147200000",
    "number": "1235474347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22958",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441220958",
            "telephone_number": "216-595-9600",
            "fax_number": "216-595-9601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20050 HARVARD AVE",
            "address_2": "SUITE 205",
            "city": "WARRENSVILLE HEIGHTS",
            "state": "OH",
            "postal_code": "441226816",
            "telephone_number": "440-953-1898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIAL HANDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-29",
        "last_updated": "2012-11-29",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "440-953-1898",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "OH",
            "license": "35057489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0881247",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warrensville Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.