Individual provider Active NPI

Jeffrey J Janda, M.D.

  • Internal Medicine Physician
  • Fairlawn, OH
National Provider Identifier
1265436109
Registry record updated Jun 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35-080164 Issued in OH
Practice address
822 Kumho Dr
Suite 202
Fairlawn, OH 44333-9297
Phone
(330) 576-0500
Fax
(330) 576-0467
NPI assigned
Jun 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35-080164 OH Primary
Hospitalist Physician 208M00000X 35080164 OH

Addresses

Primary practice location

822 Kumho Dr
Suite 202
Fairlawn, OH 44333-9297

Mailing address

822 Kumho Dr
Suite 202
Fairlawn, OH 44333-9297
Phone (330) 576-0500

Other identifiers 2

IdentifierTypeStateIssuer
JA4085792MedicaidOH
2327557MedicaidOH

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060808000596 OH Practitioner - HospitalistPractitioner - Internal Medicine 7810990041 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35-080164OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Richland County, LTD Internal Medicine CurrentSince Jun 1, 2016 Accepting new patients
NPCS Inc Hospitalist Past Accepting new patients

Locations

1320 Timken Mercy Dr NW
Canton, OH 44708
Phone (330) 489-1000

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275436800000",
    "number": "1265436109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "822 KUMHO DR",
            "address_2": "SUITE 202",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443339297",
            "telephone_number": "330-576-0500",
            "fax_number": "330-576-0467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 KUMHO DR",
            "address_2": "SUITE 202",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443339297",
            "telephone_number": "330-576-0500",
            "fax_number": "330-576-0467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANDA",
        "first_name": "JEFFREY",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2010-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35-080164",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OH",
            "license": "35080164",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "JA4085792",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2327557",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairlawn, OH

Sources for this page

Verify at the official NPI Registry.