Individual provider Active NPI

Jamere Denise Wilder

  • Non-emergency Medical Transport (VAN)
  • South Euclid, OH
National Provider Identifier
1386472108
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
Practice address
4076 Okalona Rd
South Euclid, OH 44121-2624
Phone
(216) 937-5103
NPI assigned
Jul 23, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X Primary

Addresses

Primary practice location

4076 Okalona Rd
South Euclid, OH 44121-2624

Mailing address

4076 Okalona Rd
South Euclid, OH 44121-2624
Phone (216) 937-5103

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

NPI Registry JSON

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

{
    "created_epoch": "1721692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1386472108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4076 OKALONA RD",
            "city": "SOUTH EUCLID",
            "state": "OH",
            "postal_code": "441212624",
            "telephone_number": "216-937-5103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4076 OKALONA RD",
            "city": "SOUTH EUCLID",
            "state": "OH",
            "postal_code": "441212624",
            "telephone_number": "216-937-5103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDER",
        "first_name": "JAMERE",
        "middle_name": "DENISE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-23",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Euclid, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; 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.