Organization Active NPI

D. Suzi Jagoditz

  • Durable Medical Equipment & Medical Supplies
  • Fairfield, OH
National Provider Identifier
1295860229
Registry record updated Aug 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
D. SUZI JAGODITZ
Practice address
630 Nilles Rd
Fairfield, OH 45014
Phone
(513) 829-8988
Fax
(513) 829-8988
NPI assigned
Feb 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2008

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

Authorized official

Name
D.Suzi Jagoditz
Title
Owner
Phone
(513) 829-8988

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

630 Nilles Rd
Fairfield, OH 45014

Mailing address

630 Nilles Rd
Fairfield, OH 45014
Phone (513) 829-8988

Other identifiers 2

IdentifierTypeStateIssuer
000000253723OtherOHANTHEM PIN
57718OtherOHNORTHWOOD NPN PIN

Other names 1

  • Jag's Doing business as

National Provider Directory

National Provider Directory

Locations

630 Nilles Rd
Fairfield, OH 45014
Phone (513) 829-8988

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219017600000",
    "number": "1295860229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 NILLES RD",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "45014",
            "telephone_number": "513-829-8988",
            "fax_number": "513-829-8988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 NILLES RD",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "45014",
            "telephone_number": "513-829-8988",
            "fax_number": "513-829-8988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D. SUZI JAGODITZ",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2008-08-18",
        "status": "A",
        "authorized_official_last_name": "JAGODITZ",
        "authorized_official_first_name": "D.SUZI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "513-829-8988"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "000000253723",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTHWOOD NPN PIN",
            "identifier": "57718",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jag's",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fairfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2008; 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.