Individual provider Active NPI

Jared Berger

  • Orthopedic Physical Therapist
  • Avon, OH
National Provider Identifier
1356979025
Registry record updated Mar 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT017875 Issued in OH
Practice address
33100 Cleveland Clinic Blvd
Physical Therapy Department
Avon, OH 44011
Phone
(440) 695-4000
Fax
(440) 695-4198
NPI assigned
Mar 30, 2020
Last updated
Mar 30, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT017875 OH Primary

Addresses

Primary practice location

33100 Cleveland Clinic Blvd
Physical Therapy Department
Avon, OH 44011

Mailing address

33100 Cleveland Clinic Blvd
Physical Therapy Department
Avon, OH 44011

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

State licenses

LicenseStateTypeSpecialty
PT017875OHMDOrthopedic Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1585526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585526400000",
    "number": "1356979025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33100 CLEVELAND CLINIC BLVD",
            "address_2": "PHYSICAL THERAPY DEPARTMENT",
            "city": "AVON",
            "state": "OH",
            "postal_code": "44011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33100 CLEVELAND CLINIC BLVD",
            "address_2": "PHYSICAL THERAPY DEPARTMENT",
            "city": "AVON",
            "state": "OH",
            "postal_code": "44011",
            "telephone_number": "440-695-4000",
            "fax_number": "440-695-4198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGER",
        "first_name": "JARED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-30",
        "last_updated": "2020-03-30",
        "certification_date": "2020-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "OH",
            "license": "PT017875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2020; 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.