Vivian A. Clark-Jacobs, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

50000747 Issued in OH

Practice address

8300 Hough Avenue
Cleveland, OH 44103

Phone

(216) 231-7700

Fax

(216) 231-7920

NPI assigned

Oct 3, 2006

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

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

Specialty

Physician Assistant

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cleveland Clinic Hospital, Cleveland, OH, CCN 360180

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919
  Medicare reassignment Care Compare group NPD
• University Hospitals Medical Group Inc

  • Multi-Specialty Clinic/Center
  • Cleveland, OH
  • NPI 1669499414
  Medicare reassignment NPD
• American Current Care of Ohio PA Co

  • Urgent Care Clinic/Center
  • Addison, TX
  • NPI 1023292943

  OH

  Medicare reassignment NPD
• The Cleveland Clinic Foundation

  • Family Medicine Physician
  • Avon, OH
  • NPI 1184428336
  NPD

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

• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919
  Care Compare affiliation

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203033600000",
    "number": "1972698355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8300 HOUGH AVENUE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44103",
            "telephone_number": "216-231-7700",
            "fax_number": "216-231-7920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 HOUGH AVENUE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44103",
            "telephone_number": "216-231-7700",
            "fax_number": "216-231-7920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK-JACOBS",
        "first_name": "VIVIAN",
        "middle_name": "A.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2008-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50000747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary Clapp, SRNA, MSN, RN, CCRN
• Michaela Clarahan
• Jeffrey A Claridge, MD
• Clarity Wellness Behavioral Health Center, LLC
• Nadia Angela Clarizia, MD
• Alexis Breaja Clark
• Allison Rae Clark, LPCC
• Alyssa Clark, OTR/L
• Bernadette Clark, QMHS 3YRS CMS HS
• Brian K Clark Sr.

• Medical Physician Assistant in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Medical Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.