Individual provider Active NPI

Jacqueline Jo Ann Bertolette

  • Homemaker
  • Willoughby, OH
National Provider Identifier
1245073899
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
HomemakerTaxonomy code 376J00000X
License
RJ670249 Issued in OH
Practice address
38614 Plains CT
Willoughby, OH 44094-7157
Phone
(440) 364-7371
NPI assigned
Jun 13, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Homemaker 376J00000X RJ670249 OH Primary

Addresses

Primary practice location

38614 Plains CT
Willoughby, OH 44094-7157

Mailing address

38614 Plains CT
Willoughby, OH 44094-7157

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

State licenses

LicenseStateTypeSpecialty
RJ670249OHMDHomemaker

NPI Registry JSON

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

{
    "created_epoch": "1718236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1245073899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38614 PLAINS CT",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440947157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38614 PLAINS CT",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440947157",
            "telephone_number": "440-364-7371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTOLETTE",
        "first_name": "JACQUELINE",
        "middle_name": "JO ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-13",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": "OH",
            "license": "RJ670249",
            "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 Jun 13, 2024; 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.