Individual provider Active NPI

Jillian Leigh Doerr, PA-C

  • Physician Assistant
  • Parma, OH
National Provider Identifier
1609143668
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.003424 Issued in OH
Practice address
1400 W Pleasant Valley Rd
Parma, OH 44134-6720
Phone
(440) 334-7173
NPI assigned
Nov 18, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.003424 OH Primary

Addresses

Primary practice location

1400 W Pleasant Valley Rd
Parma, OH 44134-6720

Mailing address

31642 Newbury Blvd
Avon Lake, OH 44012-2054
Phone (440) 396-6345

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20120111000881 OH Practitioner - Physician Assistant 9931376191 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50.003424OHMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: jillian.doerr.1@9327.direct.athenahealth.com
  • Direct secure messaging: jillian.doerr.1@31377.direct.athenahealth.com

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1321574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1609143668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31642 NEWBURY BLVD",
            "city": "AVON LAKE",
            "state": "OH",
            "postal_code": "440122054",
            "telephone_number": "440-396-6345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 W PLEASANT VALLEY RD",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "441346720",
            "telephone_number": "440-334-7173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOERR",
        "first_name": "JILLIAN",
        "middle_name": "LEIGH",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-18",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.003424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parma, OH

Sources for this page

Verify at the official NPI Registry.