Organization Active NPI

Janet Gobrogge CNP LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Fairlawn, OH
National Provider Identifier
1669831228
Registry record updated Feb 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
NP 10445 Issued in OH
Legal business name
JANET GOBROGGE CNP LLC
Practice address
3250 W Market St
Suite 210
Fairlawn, OH 44333-3336
Phone
(330) 864-5100
NPI assigned
Feb 11, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2016

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

Authorized official

Name
Janet Louise Gobrogge, CNPNPI 1992890867
Title
Owner
Phone
(330) 864-5100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X NP 10445 OH Primary

Addresses

Primary practice location

3250 W Market St
Suite 210
Fairlawn, OH 44333-3336

Mailing address

3250 W Market St
Suite 210
Fairlawn, OH 44333-3336
Phone (330) 864-5100

Other identifiers 1

IdentifierTypeStateIssuer
0061215MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160224001847 OH Part B Supplier - Clinic/Group Practice 1850696147 Receives reassigned benefits from 1 practitioner
Practice locations: Fairlawn, OH; New Philadelphia, OH

National Provider Directory

National Provider Directory

Locations

3250 W Market St
Ste 210
Fairlawn, OH 44333
Phone (330) 864-5100

3250 W Market St
Ste 101
Fairlawn, OH 44333
Phone (330) 864-0600

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1455148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455148800000",
    "number": "1669831228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3250 W MARKET ST",
            "address_2": "SUITE 210",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443333336",
            "telephone_number": "330-864-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3250 W MARKET ST",
            "address_2": "SUITE 210",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443333336",
            "telephone_number": "330-864-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JANET GOBROGGE CNP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-11",
        "last_updated": "2016-02-11",
        "status": "A",
        "authorized_official_last_name": "GOBROGGE",
        "authorized_official_first_name": "JANET",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-864-5100",
        "authorized_official_credential": "CNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "NP 10445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0061215",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairlawn, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.