MRS. JANE R BAGNALL (NPI# 1366091092) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366091092 |
| Entity Type | Individual |
| Full Name | MRS. JANE R BAGNALL |
| Credential | PRS |
| Practice Address |
209 Center St Chardon OH 44024-1189 |
| Practice Telephone | 4402052670 |
| Practice Fax Number | 4402858543 |
| Mailing Telephone | 4402052670 |
| Mailing Fax Number | 4402858543 |
| Enumeration Date | 2019-09-05 |
| Last Update Date | 2019-09-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | 0001422 | OH | Other Service Providers |
| Street Address |
209 CENTER ST |
| City | CHARDON |
| State | OH |
| Zip Code | 44024-1189 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356872733 | James Alexis Konnoff | Counselor | 209 Center St, Chardon, OH 44024-1189 | 2017-03-27 |
| 1831297852 | Lake-geauga Recovery Centers, Inc. | Substance Abuse Rehabilitation Facility | 209 Center St, Unit E, Chardon, OH 44024-1189 | 2006-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992336770 | Amanda Nicole Nelson | Technician, Other | 133 Up Main St, Chardon, OH 44024 | 2020-01-30 |
| 1679067011 | Janai Marshae Seng | Dentist | 401 South Street #3a, Chardon, OH 44024 | 2018-06-19 |
| 1376036475 | Kasandra Leigh Chapman | Social Worker | 12941 Ravenna Road, Chardon, OH 44024 | 2018-06-13 |
| 1275068652 | Danielle Tilton | Nurse Practitioner | 531 Fifth Ave, Chardon, OH 44024 | 2017-04-24 |
| 1881057040 | Erin Marie Moore | Counselor | 203 Main St., Chardon, OH 44024 | 2016-04-04 |
| 1649689886 | Hope Anne Super | Speech-Language Pathologist | 100 7th Av Suite 255, Chardon, OH 44024 | 2014-08-12 |
| 1740600022 | Elisha Tzvi Fredman | Student in an Organized Health Care Education/Training Program | 13207 Chardon Road, Ravenna, OH 44024 | 2014-04-24 |
| 1083039309 | Jamie Delvecchio | Family Medicine | 150 7th Ave Ste 200, Chardon, OH 44024 | 2014-02-24 |
| 1174947212 | Frank Scarano | Psychologist | 470 Center Street, Chardon, OH 44024 | 2014-02-10 |
| 1659706497 | Jamie Henderson | Physical Therapy Assistant | 9348 South Brown Rd, Chardon, OH 44024 | 2013-09-12 |
| Find all providers in zip 44024 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669946224 | John Dorsey | Peer Specialist | 695 South St, Chardon, OH 44024-1474 | 2019-01-17 |
| 1750888269 | Deborah Lynn Kowal | Peer Specialist | 12557 Ravenwood Dr, Chardon, OH 44024-9009 | 2018-04-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912508318 | Rosemarie Czechanski | Peer Specialist | 163 E Bridge St Apt 308, Berea, OH 44017-2187 | 2020-11-03 |
| 1396345989 | Kyle Johnston | Peer Specialist | 10525 Clifton Blvd Apt 3, Cleveland, OH 44102-1586 | 2020-11-01 |
| 1053911792 | Ryan Caleb Thomason | Peer Specialist | 3554 Raymont Blvd, University Heights, OH 44118-2604 | 2020-10-30 |
| 1104425883 | David Lashore Thomas | Peer Specialist | 55 W Bagley Rd, Berea, OH 44017-1916 | 2020-10-22 |
| 1871192039 | Terra Lynn Davis | Peer Specialist | 1074 Larkens Way, Medina, OH 44256-1277 | 2020-10-20 |
| 1972101012 | Cindy Ann Kozlik | Peer Specialist | 600 W.superior Ave, Cleveland, OH 44113 | 2020-10-12 |
| 1053918565 | Tina Louise Neal | Peer Specialist | 3637 Green Rd, Cleveland, OH 44122-5779 | 2020-10-07 |
| 1326645805 | Kristen Krajewski | Peer Specialist | 3105 Woodbridge Ave, Cleveland, OH 44109-2175 | 2020-10-07 |
| 1659978500 | Brandy Dawn Altop | Peer Specialist | 9221 Hooper Rd, Athens, OH 45701-3365 | 2020-10-05 |
| 1649887993 | Patricia A Mairet | Peer Specialist | 23 W College Ave, Springfield, OH 45504-2506 | 2020-09-29 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.