Active NPI
Heather Hulali Jacob, FNP-C
- Family Nurse Practitioner
- Mentor, OH
National Provider Identifier
1295402030
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- APRN.CNP.0029555
- Practice address
- 8655 Market St
Mentor, OH 44060-4112 - Phone
- (440) 255-6400
- Fax
- (440) 255-3637
- NPI assigned
- Aug 28, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APRN.CNP.0029555 | OH | Primary |
Addresses
Primary practice location
8655 Market St
Mentor, OH 44060-4112
Mailing address
2940 E Overlook Rd
Cleveland Heights, OH 44118-2434
Phone (602) 284-1702
Other practice location 1
29804 Lake Shore Blvd
Willowick, OH 44095-4611
Phone (440) 585-3322
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)
- Enrolled
- Credentials
- Certified Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN.CNP.0029555 | OH | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638144000000",
"number": "1295402030",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2940 E OVERLOOK RD",
"city": "CLEVELAND HEIGHTS",
"state": "OH",
"postal_code": "441182434",
"telephone_number": "602-284-1702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8655 MARKET ST",
"city": "MENTOR",
"state": "OH",
"postal_code": "440604112",
"telephone_number": "440-255-6400",
"fax_number": "440-255-3637"
}
],
"practiceLocations": [
{
"address_1": "29804 Lake Shore Blvd",
"address_purpose": "LOCATION",
"city": "Willowick",
"state": "OH",
"postal_code": "440954611",
"country_code": "US",
"telephone_number": "440-585-3322",
"fax_number": "440-585-1962",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACOB",
"first_name": "HEATHER",
"middle_name": "HULALI",
"credential": "FNP-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-08-28",
"last_updated": "2021-11-29",
"certification_date": "2021-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OH",
"license": "APRN.CNP.0029555",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mentor, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.