Individual provider Active NPI

Cynthia Julia Jemiola, O.D.

  • Optometrist
  • Cleveland, OH
National Provider Identifier
1689623217
Registry record updated Aug 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3452-T830 Issued in OH
Practice address
200 Public SQ
Suite 219
Cleveland, OH 44114-2316
Phone
(216) 621-2815
Fax
(216) 621-1745
NPI assigned
May 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3452-T830 OH Primary

Addresses

Primary practice location

200 Public SQ
Suite 219
Cleveland, OH 44114-2316

Mailing address

200 Public SQ
Suite 219
Cleveland, OH 44114-2316
Phone (216) 621-2815

Other identifiers 1

IdentifierTypeStateIssuer
0481572MedicaidOH

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
3452-T830OHMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344556800000",
    "number": "1689623217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 PUBLIC SQ",
            "address_2": "SUITE 219",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441142316",
            "telephone_number": "216-621-2815",
            "fax_number": "216-621-1745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PUBLIC SQ",
            "address_2": "SUITE 219",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441142316",
            "telephone_number": "216-621-2815",
            "fax_number": "216-621-1745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEMIOLA",
        "first_name": "CYNTHIA",
        "middle_name": "JULIA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2012-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3452-T830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0481572",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.

Verify at the official NPI Registry.