Jacquelynn Mary Shank

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.004322 Issued in OH

Practice address

5001 Rockside Rd
Independence, OH 44131

Phone

(216) 986-4000

NPI assigned

Mar 16, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cleveland Clinic Hospital, Cleveland, OH, CCN 360180
• Akron General Medical Center Hospital, Akron, OH, CCN 360027
• Marymount Hospital Hospital, Garfield Heights, OH, CCN 360143

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jshankpac1368597@direct.ccf.org

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.

• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919
  Medicare reassignment Care Compare group NPD
• Cleveland Clinic Mercy Hospital

  • General Acute Care Hospital
  • Canton, OH
  • NPI 1366433195
  Medicare reassignment NPD
• Cleveland Clinic Mercy Hospital

  • Dental Clinic/Center
  • Canton, OH
  • NPI 1023362100
  NPD
• Euclid Hospital Cleveland Clinic Health System

  • General Acute Care Hospital
  • Euclid, OH
  • NPI 1457403016
  NPD
• The Cleveland Clinic Foundation

  • Family Medicine Physician
  • Avon, OH
  • NPI 1184428336
  NPD
• Alliance Community Medical Foundation LLC

  • Exclusive Provider Organization
  • Alliance, OH
  • NPI 1699929562
  NPD (past)
• Premier Healht Associates Inc

  • Internal Medicine Physician
  • Alliance, OH
  • NPI 1689629065
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Akron General Medical Center

  • General Acute Care Hospital
  • Akron, OH
  • NPI 1821035940
  Care Compare affiliation
• Marymount Hospital Inc

  • General Acute Care Hospital
  • Garfield Heights, OH
  • NPI 1942248737
  Care Compare affiliation
• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919
  Care Compare affiliation

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

{
    "created_epoch": "1426464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560729600000",
    "number": "1235522244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 BRECKSVILLE RD",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441315032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 ROCKSIDE RD",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "44131",
            "telephone_number": "216-986-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 E State St",
            "address_purpose": "LOCATION",
            "city": "Alliance",
            "state": "OH",
            "postal_code": "446014936",
            "country_code": "US",
            "telephone_number": "300-596-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANK",
        "first_name": "JACQUELYNN",
        "middle_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-16",
        "last_updated": "2019-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.004322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Senior Assist Care, Inc.
• Senior Select Inc.
• Kimberly Ann Sexton, M.S., R.D.N.,L.D
• Hardeepak Shah, M.D.
• Michelle A Shakur
• Denise Ann Shannon
• Kara Shepherd
• Kerry Shidel, OT/L
• Shines Support LTD
• Billie J Shook, CNP

• Physician Assistant in Independence, OH
• Providers in Independence, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.