Individual provider Active NPI

Jacquelyn M Gill, CNP

  • Acute Care Nurse Practitioner
  • Cleveland, OH
National Provider Identifier
1285915702
Registry record updated Dec 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
COA.12510-NP Issued in OH
Practice address
9500 Euclid Ave # E1-001
Cleveland, OH 44195-2433
Phone
(216) 444-8486
NPI assigned
Aug 30, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X COA.12510-NP OH Primary

Addresses

Primary practice location

9500 Euclid Ave # E1-001
Cleveland, OH 44195-2433

Mailing address

190 Chester Ave
Wadsworth, OH 44281-8363

Other practice location 1

400 Wabash Ave
Suite 9004
Akron, OH 44307-2433
Phone (330) 344-5995

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111021000521 OH Practitioner - Nurse Practitioner 7911170725 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

1 Akron General Ave
Akron, OH 44307-2432

18101 Lorain Ave
Cleveland, OH 44111-5612
Phone (216) 671-2205

8950 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-8950

9500 Euclid Ave
Cleveland, OH 44195-0001

Hospital & facility affiliations

  • Akron General Medical Center Hospital, Akron, OH, CCN 360027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
COA.12510-NPOHMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients
The Cleveland Clinic Foundation CurrentSince Nov 29, 2016 Accepting new patients

Locations

525 E Market St
Akron, OH 44304
Phone (330) 375-6350

1 Akron General Ave
Akron, OH 44307
Phone (330) 344-5760

4125 Medina Rd
Akron, OH 44333
Phone (330) 375-8104

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

9500 Euclid Ave
#E1001
Cleveland, OH 44195
Phone (216) 444-8486

3600 W Market St
Ste 102
Fairlawn, OH 44333
Phone (330) 436-0950

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

Interoperability endpoints

  • Direct secure messaging: jgill421793@direct.ccf.org

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1314662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575331200000",
    "number": "1285915702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 CHESTER AVE",
            "city": "WADSWORTH",
            "state": "OH",
            "postal_code": "442818363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE # E1-001",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441952433",
            "telephone_number": "216-444-8486"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Wabash Ave",
            "address_2": "Suite 9004",
            "address_purpose": "LOCATION",
            "city": "Akron",
            "state": "OH",
            "postal_code": "443072433",
            "country_code": "US",
            "telephone_number": "330-344-5995",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILL",
        "first_name": "JACQUELYN",
        "middle_name": "M",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-30",
        "last_updated": "2019-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "COA.12510-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.