Individual provider Active NPI

Jacquelyn Anne Eureka, RN, BSN

  • Family Nurse Practitioner
  • Valley City, OH
National Provider Identifier
1639703200
Registry record updated May 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.0026802 Issued in OH
Practice address
6605 Center Rd
Valley City, OH 44280-9748
Phone
(330) 483-3135
NPI assigned
Feb 23, 2020
Last updated
May 13, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.0026802 OH Primary
Registered Nurse 163W00000X 386857 OH

Addresses

Primary practice location

6605 Center Rd
Valley City, OH 44280-9748

Mailing address

17045 Greenwood Dr
Strongsville, OH 44149-5822
Phone (330) 636-1908

Other practice location 1

5790 Great Northern Blvd Apt B2
North Olmsted, OH 44070-5605
Phone (330) 636-1908

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
I20220725001584 OH Practitioner - Nurse Practitioner 3779964572 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-5433

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Certified Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
386857OHMDRegistered Nurse
APRN.CNP.0026802OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation CurrentSince May 11, 2022 Accepting new patients

Locations

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

6605 Center Rd
Valley City, OH 44280
Phone (330) 483-3135

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1582416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652400000000",
    "number": "1639703200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17045 GREENWOOD DR",
            "city": "STRONGSVILLE",
            "state": "OH",
            "postal_code": "441495822",
            "telephone_number": "330-636-1908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6605 CENTER RD",
            "city": "VALLEY CITY",
            "state": "OH",
            "postal_code": "442809748",
            "telephone_number": "330-483-3135"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5790 Great Northern Blvd Apt B2",
            "address_purpose": "LOCATION",
            "city": "North Olmsted",
            "state": "OH",
            "postal_code": "440705605",
            "country_code": "US",
            "telephone_number": "330-636-1908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EUREKA",
        "first_name": "JACQUELYN",
        "middle_name": "ANNE",
        "credential": "RN, BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-23",
        "last_updated": "2022-05-13",
        "certification_date": "2022-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0026802",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "386857",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley City, OH

Sources for this page

Verify at the official NPI Registry.