Individual provider Active NPI

Jamie Livchak, RN

  • Registered Nurse
  • Lakewood, OH
National Provider Identifier
1780066522
Registry record updated Jun 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN256105 Issued in OH
Practice address
12701 Arliss Dr
Lakewood, OH 44107-2106
Phone
(216) 338-0545
NPI assigned
Jun 28, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN256105 OH Primary

Addresses

Primary practice location

12701 Arliss Dr
Lakewood, OH 44107-2106

Mailing address

12701 Arliss Dr
Lakewood, OH 44107-2106
Phone (216) 338-0545

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN256105OHMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1435449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435449600000",
    "number": "1780066522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12701 ARLISS DR",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441072106",
            "telephone_number": "216-338-0545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12701 ARLISS DR",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441072106",
            "telephone_number": "216-338-0545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVCHAK",
        "first_name": "JAMIE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-28",
        "last_updated": "2015-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN256105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2015; 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.