Individual provider Active NPI

Jesse V McClain, CNS

  • Adult Health Clinical Nurse Specialist
  • Youngstown, OH
National Provider Identifier
1396891792
Registry record updated Jan 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X
License
APRN.CNS.09249 Issued in OH
Practice address
1340 Belmont Ave
Ste 2200
Youngstown, OH 44504-1125
Phone
(330) 746-7400
Fax
(330) 746-7436
NPI assigned
Jan 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Clinical Nurse Specialist 364SA2200X APRN.CNS.09249 OH Primary

Addresses

Primary practice location

1340 Belmont Ave
Ste 2200
Youngstown, OH 44504-1125

Mailing address

1340 Belmont Ave
Ste 2200
Youngstown, OH 44504-1125
Phone (330) 746-7400

Other identifiers 3

IdentifierTypeStateIssuer
H166150OtherOHMEDICARE PTAN
MCNS03831OtherOHMEDICARE PTAN
2960167MedicaidOH

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20070420000063 OH Practitioner - Certified Clinical Nurse Specialist (CNS) 1254436272 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

905 Sahara TRL
Poland, OH 44514-3687
Phone (330) 729-8970

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN.CNS.09249OHMDAdult Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Jan 1, 2022 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Jan 1, 2022 Accepting new patients
Mercy Health Physicians Youngstown LLC CurrentSince Jan 2, 2013 Accepting new patients
Mercy Health Physicians Youngstown, LLC CurrentSince Jan 2, 2013 Accepting new patients

Locations

410 W 10th Ave
Columbus, OH 43210
Phone (614) 293-5905

250 E Federal St
Fl 4
Youngstown, OH 44503
Phone (330) 884-7010

1053 Belmont Ave
Youngstown, OH 44504
Phone (330) 480-3605

905 Sahara Trl
Youngstown, OH 44514
Phone (330) 726-0100

1340 Belmont Ave
Ste 2200
Youngstown, OH 44504
Phone (330) 480-7350

1044 Belmont Ave
Youngstown, OH 44504
Phone (330) 480-2182

Interoperability endpoints

  • Direct secure messaging: jmcclain17055@direct.bsmhealth.org

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483228800000",
    "number": "1396891792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 BELMONT AVE",
            "address_2": "STE 2200",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445041125",
            "telephone_number": "330-746-7400",
            "fax_number": "330-746-7436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 BELMONT AVE",
            "address_2": "STE 2200",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445041125",
            "telephone_number": "330-746-7400",
            "fax_number": "330-746-7436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLAIN",
        "first_name": "JESSE",
        "middle_name": "V",
        "credential": "CNS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2017-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "OH",
            "license": "APRN.CNS.09249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "H166150",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "MCNS03831",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2960167",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.