Susan Anne Jekielek, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35069999 Issued in OH

Practice address

4302 Allen Rd
Suite 400
Stow, OH 44224-1032

Phone

(330) 344-3000

Fax

(330) 920-6237

NPI assigned

Aug 9, 2005

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265155200000",
    "number": "1922009414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4302 ALLEN RD",
            "address_2": "SUITE 400",
            "city": "STOW",
            "state": "OH",
            "postal_code": "442241032",
            "telephone_number": "330-344-3000",
            "fax_number": "330-920-6237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4302 ALLEN RD",
            "address_2": "SUITE 400",
            "city": "STOW",
            "state": "OH",
            "postal_code": "442241032",
            "telephone_number": "330-344-3000",
            "fax_number": "330-920-6237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEKIELEK",
        "first_name": "SUSAN",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2010-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35069999",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2041552",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080145152",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelsey Jakupca
• James P Maurer DDS, Inc
• Tara N Janson, PTA
• Christine Jarrett
• JDS Vision LLC
• Jilliane Pugh LLC
• Cicely Nicole Johnson, NURSE PRACTITIONER
• Donna M Johnson, MA CCC-A
• Michael Bryan Johnson, LPCC
• Teneika Johnson

• Family Medicine Physician in Stow, OH
• Providers in Stow, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2010; 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.