Mark Jakomin

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT.002726 Issued in OH

Practice address

29017 Chardon Rd
Willoughby Hills, OH 44092-1405

Phone

(440) 516-5400

Fax

(440) 516-5197

NPI assigned

Apr 10, 2014

Last updated

Apr 10, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919
  NPD (past)

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

{
    "created_epoch": "1397088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397088000000",
    "number": "1316366966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2730 MORNING STAR CT",
            "city": "WILLOUGHBY HILLS",
            "state": "OH",
            "postal_code": "440949800",
            "telephone_number": "440-944-6997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29017 CHARDON RD",
            "city": "WILLOUGHBY HILLS",
            "state": "OH",
            "postal_code": "440921405",
            "telephone_number": "440-516-5400",
            "fax_number": "440-516-5197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAKOMIN",
        "first_name": "MARK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-10",
        "last_updated": "2014-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT.002726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Indu Sivaraman MD LLC
• Madalyn Nicole Issa
• Brian E Jackson, DDS
• Janae Jackson
• Thurayyah Jackson
• Alison Renee Janzen, DPT
• Vanessa K Jensen, PSYD
• Angelic E Jimenez
• JNR Behavioral Therapy & Mediation Services
• Daijona Johnson

• Physical Therapist in Willoughby Hills, OH
• Providers in Willoughby Hills, OH by specialty
• Physical Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2014; 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.