Jeanine R Willis, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

COA.15100-NP Issued in OH

Practice address

18099 Lorain Ave Ste 445
Cleveland, OH 44111-5610

Phone

(440) 886-1800

NPI assigned

Sep 13, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Comprehensive Pain Care Center, IncGroup PAC ID 4385682624, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cleveland Clinic Hospital, Cleveland, OH, CCN 360180
• Cleveland Clinic Avon Hospital Hospital, Avon, OH, CCN 360364
• Fairview Hospital Hospital, Cleveland, OH, CCN 360077

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Comprehensive Pain Care Center, Inc

  • Specialist
  • Lorain, OH
  • NPI 1124095112
  Medicare reassignment Care Compare group NPD
• Emh Regional Medical Center

  • General Acute Care Hospital
  • Elyria, OH
  • NPI 1841299039
  Medicare reassignment NPD
• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919
  Medicare reassignment NPD
• Wooster Clinic, LLC

  • Multi-Specialty Clinic/Center
  • Wooster, OH
  • NPI 1033135009
  Medicare reassignment NPD
• Emh Regional Medical Center

  • Nurse Practitioner
  • Elyria, OH
  • NPI 1629422480
  NPD
• Fairview Hospital

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1215989611
  NPD (past)

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

• Cleveland Clinic Avon Hospital

  • General Acute Care Hospital
  • Avon, OH
  • NPI 1346607017
  Care Compare affiliation
• Fairview Hospital

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1215989611
  Care Compare affiliation
• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919
  Care Compare affiliation

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

{
    "created_epoch": "1379030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674345600000",
    "number": "1356776975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18099 LORAIN AVE STE 445",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441115610",
            "telephone_number": "440-886-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18099 LORAIN AVE STE 445",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441115610",
            "telephone_number": "440-886-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "JEANINE",
        "middle_name": "R",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-13",
        "last_updated": "2023-01-22",
        "certification_date": "2023-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA.15100-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0096370",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Colette Willins, MD
• Bridgett Willis, LPC
• Dameyonna Shakim Willis
• Deborah Willis, LISWS
• Jamie Willis
• Jennifer Willis
• Jessica Lee Willis, LPN
• Joanne M Willis, LPN
• Joseph E Willis, MD
• La Shanda D Willis, MA

• Family Nurse Practitioner in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.