Individual provider Active NPI

Jamie Matkovic, PHARMD

  • Pharmacist
  • Cleveland, OH
National Provider Identifier
1346783529
Registry record updated Nov 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03125818 Issued in OH
Practice address
2500 Metrohealth Dr
Outpatient Plaza Pharmacy
Cleveland, OH 44109-1900
Phone
(216) 778-7297
Fax
(216) 778-1055
NPI assigned
Nov 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 03125818 OH Primary

Addresses

Primary practice location

2500 Metrohealth Dr
Outpatient Plaza Pharmacy
Cleveland, OH 44109-1900

Mailing address

2500 Metrohealth Dr
Outpatient Plaza Pharmacy
Cleveland, OH 44109-1900
Phone (216) 778-7297

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)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
03125818OHMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1479686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479686400000",
    "number": "1346783529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 METROHEALTH DR",
            "address_2": "OUTPATIENT PLAZA PHARMACY",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441091900",
            "telephone_number": "216-778-7297",
            "fax_number": "216-778-1055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 METROHEALTH DR",
            "address_2": "OUTPATIENT PLAZA PHARMACY",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441091900",
            "telephone_number": "216-778-7297",
            "fax_number": "216-778-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATKOVIC",
        "first_name": "JAMIE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-21",
        "last_updated": "2016-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03125818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2016; 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.