Active NPI
Jacqueline Reid
- Driver
- South Euclid, OH
National Provider Identifier
1407462328
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- 1816020
- Practice address
- 453 Greenvale Rd
South Euclid, OH 44121-2310 - Phone
- (216) 534-8276
- NPI assigned
- Sep 16, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | 1816020 | OH | Primary |
Addresses
Primary practice location
453 Greenvale Rd
South Euclid, OH 44121-2310
Mailing address
453 Greenvale Rd
South Euclid, OH 44121-2310
Phone (216) 534-8276
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 189779802901 | Medicaid | OH |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1816020 | OH | MD | Driver |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600214400000",
"number": "1407462328",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "453 GREENVALE RD",
"city": "SOUTH EUCLID",
"state": "OH",
"postal_code": "441212310",
"telephone_number": "216-534-8276"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "453 GREENVALE RD",
"city": "SOUTH EUCLID",
"state": "OH",
"postal_code": "441212310",
"telephone_number": "216-534-8276"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REID",
"first_name": "JACQUELINE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-09-16",
"last_updated": "2020-09-16",
"certification_date": "2020-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "OH",
"license": "1816020",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "189779802901",
"state": "OH"
}
],
"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 Sep 16, 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.