Individual provider Active NPI

Jeffrey Remaklus

  • Family Nurse Practitioner
  • Fremont, OH
National Provider Identifier
1497113120
Registry record updated Feb 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
COA.18702-NP Issued in OH
Practice address
410 Birchard Ave
Fremont, OH 43420-2967
Phone
(419) 334-3869
NPI assigned
Feb 9, 2016
Last updated
Feb 9, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X COA.18702-NP OH Primary

Addresses

Primary practice location

410 Birchard Ave
Fremont, OH 43420-2967

Mailing address

410 Birchard Ave
Fremont, OH 43420-2967
Phone (419) 334-3869

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160609000760 OH Practitioner - Nurse Practitioner 5991095515 Reassigns benefits to 1 organization
I20180730002756 GA Practitioner - Nurse Practitioner 5991095515 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
COA.18702-NPOHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Grady Memorial Hospital Corporation CurrentSince Jun 9, 2018 Accepting new patients
Compassion Health Toledo CurrentSince Jul 1, 2022 Accepting new patients
Grady Memorial Hospital Corporation CurrentSince Jun 9, 2018 Accepting new patients
Compassion Health Toledo CurrentSince Jul 1, 2022 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Community and Rural Health Services PastSince Apr 13, 2016 Accepting new patients

Locations

1863 Memorial Dr SE
Atlanta, GA 30317
Phone (404) 616-8880

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

80 Jesse Hill Jr Dr SE
#88
Atlanta, GA 30303
Phone (404) 616-0879

1638 Broadway St
Toledo, OH 43609
Phone (567) 661-0565

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1454976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454976000000",
    "number": "1497113120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 BIRCHARD AVE",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434202967",
            "telephone_number": "419-334-3869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 BIRCHARD AVE",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434202967",
            "telephone_number": "419-334-3869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REMAKLUS",
        "first_name": "JEFFREY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-09",
        "last_updated": "2016-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA.18702-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, OH

Sources for this page

Verify at the official NPI Registry.