Jla Senior Footcare Oh PA LLC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

36003012 Issued in OH

Legal business name

JLA SENIOR FOOTCARE OH PA LLC

Practice address

6715 Tippecanoe Rd BLDG F
Canfield, OH 44406-8180

Phone

(330) 702-0978

Fax

(330) 286-3202

NPI assigned

Aug 30, 2010

Organization subpart

No

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

Authorized official

Name

Anthony E Innocenzi, DPM

Title

Owner

Phone

(330) 702-0978

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1283126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308873600000",
    "number": "1376859298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4870 S ASPEN CT",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444068469",
            "telephone_number": "330-702-0978",
            "fax_number": "330-286-3202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6715 TIPPECANOE RD BLDG F",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444068180",
            "telephone_number": "330-702-0978",
            "fax_number": "330-286-3202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JLA SENIOR FOOTCARE OH PA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-30",
        "last_updated": "2011-06-24",
        "status": "A",
        "authorized_official_last_name": "INNOCENZI",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-702-0978",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36003012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3095896",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John R. Jakubek, M.D.
• Anginette James
• Josephine J Jarbeck, CRNA
• Hayley Jenkins, OTR/L
• Jjdbt Pediatrics
• Calia Renee Jones Findley
• Daniel Eugene Jones, PHARMD
• Tayla Jones
• Judy L. Daubenmire
• Brittanie N Jumbo

• Podiatrist in Canfield, OH
• Providers in Canfield, OH by specialty
• Podiatrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2011; 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.