Individual provider Active NPI

Lauren Elizabeth Jackson, PA-C

  • Physician Assistant
  • Cuyahoga Falls, OH
National Provider Identifier
1902325244
Registry record updated Dec 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
APP-000115333 Issued in OH
Practice address
857 Graham Rd
Cuyahoga Falls, OH 44221-1170
Phone
(330) 923-9585
NPI assigned
Sep 19, 2017
Last updated
Dec 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X APP-000115333 OH Primary

Addresses

Primary practice location

857 Graham Rd
Cuyahoga Falls, OH 44221-1170

Mailing address

857 Graham Rd
Cuyahoga Falls, OH 44221-1170
Phone (330) 923-9585

Other practice location 1

9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (800) 223-2273

Other practice location 2

6780 Mayfield Rd
Mayfield Heights, OH 44124-2203
Phone (440) 312-4500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171129002048 OH Practitioner - Physician Assistant 9638436629 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

4494 State Route 43
Kent, OH 44240-8206
Phone (330) 344-1600

82 W Streetsboro St
Hudson, OH 44236-2876
Phone (330) 344-7650

857 Graham Rd
Cuyahoga Falls, OH 44221-1170

8950 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-8950

9500 Euclid Ave
Cleveland, OH 44195-0001

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
APP-000115333OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation CurrentSince Oct 25, 2017 Accepting new patients

Locations

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

857 Graham Rd
Cuyahoga Falls, OH 44221
Phone (330) 923-9585

6780 Mayfield Rd
Mayfield Hts, OH 44124
Phone (440) 331-9520

Organizations & group practices 1

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1505779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608681600000",
    "number": "1902325244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "857 GRAHAM RD",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "442211170",
            "telephone_number": "330-923-9585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "857 GRAHAM RD",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "442211170",
            "telephone_number": "330-923-9585"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9500 Euclid Ave",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441950001",
            "country_code": "US",
            "telephone_number": "800-223-2273",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6780 Mayfield Rd",
            "address_purpose": "LOCATION",
            "city": "Mayfield Heights",
            "state": "OH",
            "postal_code": "441242203",
            "country_code": "US",
            "telephone_number": "440-312-4500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "LAUREN",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-19",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "APP-000115333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cuyahoga Falls, OH

Sources for this page

Verify at the official NPI Registry.