Marie Marie Jefferson

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

17825 Libby Rd
Maple Heights, OH 44137-1509

Phone

(216) 369-8550

NPI assigned

Nov 10, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Northeastern Ohio Recovery Association

  • Behavior Analyst
  • Maple Heights, OH
  • NPI 1508621616
  NPD

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

{
    "created_epoch": "1636502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1801552302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E 55TH ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441031304",
            "telephone_number": "216-391-6672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17825 LIBBY RD",
            "city": "MAPLE HEIGHTS",
            "state": "OH",
            "postal_code": "441371509",
            "telephone_number": "216-369-8550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERSON",
        "first_name": "MARIE",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-10",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "policygurl44@outlook.com",
            "affiliation": "N",
            "endpointDescription": "policygurl44@outlook.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "17825 Libby Rd",
            "city": "Maple Heights",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441371509",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shawnda Trenay Jackson, LPN
• Anthony L Jacobs I
• Jordan Jarrett
• Richard Kyle Jason
• Jaystarr Homes 2Inc
• Jeffrey J Orchen DDS Inc
• Brittany Nicole Jenkins
• Rhonda Jenkins
• Marcus Jennings
• Tierra A Jmaes, MEDICAL ASSISTANT II

• Student in an Organized Health Care Education/Training Program in Maple Heights, OH
• Providers in Maple Heights, OH by specialty
• Student in an Organized Health Care Education/Training Program in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2021; 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.