Jeffrey Paul Patrick

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CDCA.190494 Issued in OH

Practice address

11470 County Road 1
Chesapeake, OH 45619-7010

Phone

(740) 550-4991

NPI assigned

Nov 5, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Southern Hope Recovery Center LLC

  • Addiction (Substance Use Disorder) Counselor
  • Chesapeake, OH
  • NPI 1871150961
  NPD
• Southern Hope Recovery Center LLC

  • Community/Behavioral Health Agency
  • South Point, OH
  • NPI 1881518793
  NPD (past)

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

{
    "created_epoch": "1730764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1851114177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11470 COUNTY ROAD 1",
            "city": "CHESAPEAKE",
            "state": "OH",
            "postal_code": "456197010",
            "telephone_number": "740-550-4991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11470 COUNTY ROAD 1",
            "city": "CHESAPEAKE",
            "state": "OH",
            "postal_code": "456197010",
            "telephone_number": "740-550-4991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRICK",
        "first_name": "JEFFREY",
        "middle_name": "PAUL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-11-05",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.190494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ohio's Choice, Inc.
• Cornell G Orr, CDCA
• Amanda Ryan Osborne, CMS
• Zachary Parker
• Dylan Parsons
• Bradley K Pauley
• Aaron Pemberton, CDCA
• Angela F Pemberton
• Austin Pemberton
• Robert Pemberton

• Addiction (Substance Use Disorder) Counselor in Chesapeake, OH
• Providers in Chesapeake, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; 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.