Active NPI
Linda Marie Poprocki-Jake, LPN
- Licensed Practical Nurse
- Avon, OH
National Provider Identifier
1447423330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- PN111388
- Practice address
- 38585 Thorton LN
Avon, OH 44011-5208 - Phone
- (440) 856-9063
- Fax
- (440) 891-1361
- NPI assigned
- Apr 11, 2008
- 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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | PN111388 | OH | Primary |
Addresses
Primary practice location
38585 Thorton LN
Avon, OH 44011-5208
Mailing address
38585 Thorton Lane
Avon, OH 44011
Phone (440) 856-9063
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2586376 | 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 |
|---|---|---|---|
| PN111388 | OH | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459209600000",
"number": "1447423330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38585 THORTON LANE",
"city": "AVON",
"state": "OH",
"postal_code": "44011",
"telephone_number": "440-856-9063",
"fax_number": "440-891-1361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "38585 THORTON LN",
"city": "AVON",
"state": "OH",
"postal_code": "440115208",
"telephone_number": "440-856-9063",
"fax_number": "440-891-1361"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POPROCKI-JAKE",
"first_name": "LINDA",
"middle_name": "MARIE",
"credential": "LPN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-04-11",
"last_updated": "2016-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "OH",
"license": "PN111388",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2586376",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Avon, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.