Active NPI
Jesse Guardado
- Public Health or Welfare Agency
- Lorain, OH
National Provider Identifier
1508460353
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health or Welfare Agency
- License
- 4705851
- Practice address
- 2625 Vassar Ave
Lorain, OH 44053-2359 - Phone
- (440) 897-4866
- NPI assigned
- Nov 23, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Public Health or Welfare Agency | 251K00000X | 4705851 | OH | Primary |
Addresses
Primary practice location
2625 Vassar Ave
Lorain, OH 44053-2359
Mailing address
2625 Vassar Ave
Lorain, OH 44053-2359
Phone (440) 897-4866
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 |
|---|---|---|---|
| 4705851 | OH | MD | Public Health or Welfare Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606089600000",
"number": "1508460353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2625 VASSAR AVE",
"city": "LORAIN",
"state": "OH",
"postal_code": "440532359",
"telephone_number": "440-897-4866"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2625 VASSAR AVE",
"city": "LORAIN",
"state": "OH",
"postal_code": "440532359",
"telephone_number": "440-897-4866"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUARDADO",
"first_name": "JESSE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-11-23",
"last_updated": "2020-11-23",
"certification_date": "2020-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "251K00000X",
"taxonomy_group": "",
"desc": "Public Health or Welfare",
"state": "OH",
"license": "4705851",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lorain, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 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.