Active NPI
Maita Louise Jarkewicz, DO
- Family Medicine Physician
- Willoughby, OH
National Provider Identifier
1649535444
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 34.004403
- Practice address
- 4661 Maple St
Willoughby, OH 44094-5730 - Phone
- (440) 724-7471
- NPI assigned
- Jul 8, 2012
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 34.004403 | OH | Primary |
Addresses
Primary practice location
4661 Maple St
Willoughby, OH 44094-5730
Mailing address
4661 Maple St
Willoughby, OH 44094-5730
Phone (440) 724-7471
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
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34.004403 | OH | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1341705600000",
"number": "1649535444",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4661 MAPLE ST",
"city": "WILLOUGHBY",
"state": "OH",
"postal_code": "440945730",
"telephone_number": "440-724-7471"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4661 MAPLE ST",
"city": "WILLOUGHBY",
"state": "OH",
"postal_code": "440945730",
"telephone_number": "440-724-7471"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JARKEWICZ",
"first_name": "MAITA",
"middle_name": "LOUISE",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-07-08",
"last_updated": "2012-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OH",
"license": "34.004403",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Willoughby, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.