Individual provider Active NPI

Jordan Cloonan

  • Ambulatory Care Pharmacist
  • Kirtland, OH
National Provider Identifier
1265055479
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Care PharmacistTaxonomy code 1835P2201X
License
03442299 Issued in OH
Practice address
8269 Emerald Glen CT
Kirtland, OH 44094-9745
Phone
(440) 567-6483
Fax
(855) 355-3480
NPI assigned
May 21, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X OH
Ambulatory Care Pharmacist 1835P2201X 03442299 OH Primary

Addresses

Primary practice location

8269 Emerald Glen CT
Kirtland, OH 44094-9745

Mailing address

8333 Rockside Rd
Cleveland, OH 44125-6134
Phone (216) 369-2200

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
03442299OHMDAmbulatory Care Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1590019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1265055479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8333 ROCKSIDE RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441256134",
            "telephone_number": "216-369-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8269 EMERALD GLEN CT",
            "city": "KIRTLAND",
            "state": "OH",
            "postal_code": "440949745",
            "telephone_number": "440-567-6483",
            "fax_number": "855-355-3480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLOONAN",
        "first_name": "JORDAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-21",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "OH",
            "license": "03442299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirtland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.