Jackson Surgical Assistants, LLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

35.027433 Issued in OH

Legal business name

JACKSON SURGICAL ASSISTANTS, LLC

Doing business as

JSA of Ohio

Practice address

630 E River St
Elyria, OH 44035-5902

Phone

(678) 983-4479

NPI assigned

Sep 21, 2011

Organization subpart

Yes

Parent organization

JACKSON SURGICAL ASSISTANTS, LLCAs reported in NPPES

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

Authorized official

Name

Ann H Schaker

Title

Billing Director

Phone

(678) 983-4479

Specialties & licenses 4

Addresses

Other names 1

• JSA of Ohio Doing business as

Part of

Jackson Surg Assis LLC

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

{
    "created_epoch": "1316563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316563200000",
    "number": "1649553181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 543",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300090543",
            "telephone_number": "678-983-4479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 E RIVER ST",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440355902",
            "telephone_number": "678-983-4479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON SURGICAL ASSISTANTS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JACKSON SURGICAL ASSISTANTS, LLC",
        "enumeration_date": "2011-09-21",
        "last_updated": "2011-09-21",
        "status": "A",
        "authorized_official_last_name": "SCHAKER",
        "authorized_official_first_name": "ANN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "BILLING DIRECTOR",
        "authorized_official_telephone_number": "678-983-4479"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "OH",
            "license": "35.027433",
            "primary": true
        },
        {
            "code": "246ZC0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JSA of Ohio",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Tamara A. Iwaszkiw, LISW-S
• J-J Medical Service, Inc.
• Ashley Nicole Jackson
• Christy Danielle Jackson, NURSE
• Jacqueline Diane Jackson, LPN
• Lynette Jackson, LSW
• Patricia Jackson

• Surgery Physician in Elyria, OH
• Providers in Elyria, OH by specialty
• Surgery Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.