Individual provider Active NPI

Jordan Groubert, DO

  • Internal Medicine Physician
  • Akron, OH
National Provider Identifier
1902393358
Registry record updated Jun 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
34.015074 Issued in OH
Practice address
55 Arch St Ste 1B
Akron, OH 44304
Phone
(330) 375-3315
NPI assigned
Apr 20, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 34.015074 OH Primary

Addresses

Primary practice location

55 Arch St Ste 1B
Akron, OH 44304

Mailing address

55 Arch St Ste 1B
Akron, OH 44304-1436

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210604001862 OH Practitioner - Internal Medicine 1456608397 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Ohio University, College of Osteopathic Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summa Physicians LLCGroup PAC ID 2961303532, 692 clinicians

Practice addresses (Care Compare)

525 E Market St
Akron, OH 44304-1619

55 Arch St
Suite 1B
Akron, OH 44304-1436
Phone (330) 375-3315

95 Arch St
Suite 215
Akron, OH 44304-1467
Phone (330) 434-4145

Hospital & facility affiliations

  • Summa Home Health and Hospice LLC Home health agency, Akron, OH, CCN 367713
  • Summa Health System Hospital, Akron, OH, CCN 360020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Summa Physicians LLC CurrentSince Jul 26, 2021 Accepting new patients
Summa Physicians LLC Internal Medicine CurrentSince Jul 26, 2021 Accepting new patients
Summa Physicians LLC Current Accepting new patients
Summa Physicians LLC Past Accepting new patients
Summa Health System Past Accepting new patients

Locations

55 Arch St
Ste 1B
Akron, OH 44304
Phone (330) 375-7779

1077 Gorge Blvd
Akron, OH 44310
Phone (234) 312-5691

525 E Market St
Akron, OH 44304
Phone (330) 375-6350

Organizations & group practices 5

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.

Hospital & facility affiliations 4

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": "1524182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1902393358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 ARCH ST STE 1B",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443041436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 ARCH ST STE 1B",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "44304",
            "telephone_number": "330-375-3315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROUBERT",
        "first_name": "JORDAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-20",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "34.015074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

Verify at the official NPI Registry.