Individual provider Active NPI

Jillian Semonin

  • Registered Nurse
  • Canton, OH
National Provider Identifier
1245997253
Registry record updated Nov 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN.476538 Issued in OH
Practice address
4042 Cleveland Ave S # South
Canton, OH 44707-1334
Phone
(330) 484-3947
NPI assigned
Nov 24, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.476538 OH Primary

Addresses

Primary practice location

4042 Cleveland Ave S # South
Canton, OH 44707-1334

Mailing address

6097 Taylor Rd
New Franklin, OH 44216-9362

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
RN.476538OHMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Lane Drug Co PastSince Nov 28, 2021 Accepting new patients
Lane Drug Co PastSince Nov 28, 2021 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1637712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637712000000",
    "number": "1245997253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6097 TAYLOR RD",
            "city": "NEW FRANKLIN",
            "state": "OH",
            "postal_code": "442169362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4042 CLEVELAND AVE S # SOUTH",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447071334",
            "telephone_number": "330-484-3947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEMONIN",
        "first_name": "JILLIAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-24",
        "last_updated": "2021-11-24",
        "certification_date": "2021-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.476538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2021; 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.