Active NPI
Jack Ewan Brooker, MD
- Student in an Organized Health Care Education/Training Program
- Cleveland, OH
National Provider Identifier
1548729668
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- University Hospitals Case Medical Center
11100 Euclid Ave
Cleveland, OH 44106 - Phone
- (216) 844-4780
- NPI assigned
- Mar 18, 2019
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
University Hospitals Case Medical Center
11100 Euclid Ave
Cleveland, OH 44106
Mailing address
University Hospitals Case Medical Center
11100 Euclid Ave
Cleveland, OH 44106
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552867200000",
"number": "1548729668",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "UNIVERSITY HOSPITALS CASE MEDICAL CENTER",
"address_2": "11100 EUCLID AVE",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "44106"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "UNIVERSITY HOSPITALS CASE MEDICAL CENTER",
"address_2": "11100 EUCLID AVE",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "44106",
"telephone_number": "216-844-4780"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOKER",
"first_name": "JACK",
"middle_name": "EWAN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-03-18",
"last_updated": "2019-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.