Jerome Richard Vidd, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

34002393 Issued in OH

Practice address

795 Nautilus Trail
Aurora, OH 44202-8901

Phone

(216) 233-1940

Fax

(330) 562-5890

NPI assigned

May 6, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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

{
    "created_epoch": "1210032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210032000000",
    "number": "1386810794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "795 NAUTILUS TRAIL",
            "city": "AURORA",
            "state": "OH",
            "postal_code": "442028901",
            "telephone_number": "216-233-1940",
            "fax_number": "330-562-5890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "795 NAUTILUS TRAIL",
            "city": "AURORA",
            "state": "OH",
            "postal_code": "442028901",
            "telephone_number": "216-233-1940",
            "fax_number": "330-562-5890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDD",
        "first_name": "JEROME",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-06",
        "last_updated": "2008-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "34002393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marina Ucadze
• University Hospitals Laboratory Services Foundation - Aurora
• Katrina L Valenti, COTA
• Ramanii Vance
• Diana Vasylkevych, DDS
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-3250)
• Wal-Mart Stores East, LP (Wal-Mart Vision Center 30-3250)
• Walgreen Co (Walgreens #10567)
• Latia Marie Wallace, LPN
• Barbara Washington, LPN

• Internal Medicine Physician in Aurora, OH
• Providers in Aurora, OH by specialty
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2008; 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.