Active NPI
Renee Jacobellis
- Addiction (Substance Use Disorder) Registered Nurse
- Euclid, OH
National Provider Identifier
1407617194
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Registered Nurse
- License
- RN287079
- Practice address
- 20611 Euclid Ave
Euclid, OH 44117-1521 - Phone
- (440) 749-0768
- NPI assigned
- Jan 19, 2024
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Registered Nurse | 163WA0400X | RN287079 | OH | Primary |
Addresses
Primary practice location
20611 Euclid Ave
Euclid, OH 44117-1521
Mailing address
20611 Euclid Ave
Euclid, OH 44117-1521
Phone (440) 749-0768
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 |
|---|---|---|---|
| RN287079 | OH | MD | Addiction (Substance Use Disorder) Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1705622400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705622400000",
"number": "1407617194",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20611 EUCLID AVE",
"city": "EUCLID",
"state": "OH",
"postal_code": "441171521",
"telephone_number": "440-749-0768"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20611 EUCLID AVE",
"city": "EUCLID",
"state": "OH",
"postal_code": "441171521",
"telephone_number": "440-749-0768"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBELLIS",
"first_name": "RENEE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-01-19",
"last_updated": "2024-01-19",
"certification_date": "2024-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "163WA0400X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Registered Nurse, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "RN287079",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Euclid, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.