DR. MICHAEL JACK (NPI# 1780080812) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780080812 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL JACK |
| Credential | D.P.M. |
| Practice Address |
1930 State Route 59 Kent OH 44240-4112 |
| Practice Telephone | 3306733505 |
| Practice Fax Number | 3306734888 |
| Mailing Telephone | 3305966000 |
| Mailing Fax Number | 3305967752 |
| Enumeration Date | 2014-11-18 |
| Last Update Date | 2020-08-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 36.003804 | OH | Podiatric Medicine & Surgery Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 200 E State St, Medical Education-podiatry Resident, Alliance, OH 446014936 | 3305966000 | 3305967752 |
| 201 5th St Ne Ste 5, Barberton, OH 442033017 | 3308648501 | 3308648508 |
| 2950 W Market St, Fairlawn, OH 443333614 | 3308648501 | 3308648508 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538242482 | Michael Alan Jack | Dentist | 822 Portage Trail, Cuyahoga Falls, OH 44221 | 2006-10-23 |
| 1558453399 | Michael Jack | Dentist | 13403 13 Mile Rd, Warren, MI 48088 | 2006-09-29 |
| 1629023288 | Michael Jack | Nurse Anesthetist, Certified Registered | 1102 W 32nd St, Joplin, MO 64804 | 2006-05-23 |
| Street Address |
1930 STATE ROUTE 59 |
| City | KENT |
| State | OH |
| Zip Code | 44240-4112 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104821933 | Emilio D Ferrara | Dentist | 1930 State Route 59, Ste E, Kent, OH 44240-4112 | 2005-06-17 |
| 1336570480 | Rodney Scott | Podiatrist | 1930 State Route 59, Ste D, Kent, OH 44240-4112 | 2013-11-27 |
| 1093994196 | Randall H Smith Md Inc | Surgery | 1930 State Route 59, Kent, OH 44240-4112 | 2007-10-25 |
| 1477768174 | Professional Management Systems, LLC | Radiology | 1930 State Route 59, Kent, OH 44240 | 2007-05-14 |
| 1366513830 | Penn Imaging Associates PC | Radiology | 1930 State Route 59, Kent, OH 44240-4112 | 2006-11-13 |
| 1992736888 | David D.y. Lan | Radiology | 1930 State Route 59, Kent, OH 44240-4112 | 2006-07-06 |
| 1578593299 | Albert J. Cook M.d. Inc | Radiology | 1930 State Route 59, Kent, OH 44240-4112 | 2006-07-05 |
| 1619907342 | Ohio Imaging Centers Inc. | Radiology | 1930 State Route 59, Kent, OH 44240-4112 | 2006-07-05 |
| 1881623411 | Steven Douglas Stowell | Radiology | 1930 State Route 59, Kent, OH 44240-4112 | 2006-07-03 |
| 1114957792 | Albert James Cook Sr. | Radiology | 1930 State Route 59, Kent, OH 44240-4112 | 2006-07-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881201887 | Julia Repasky | Speech-Language Pathologist | 4170 Oh-43, Kent, OH 44240 | 2020-09-24 |
| 1811515000 | Natasha Loveridge | Speech-Language Pathologist | 1949 Oh-59, Suite 202, Kent, OH 44240 | 2020-07-14 |
| 1215569256 | Meijer Stores Limited Partnership | Durable Medical Equipment & Medical Supplies | 247 Tallmadge Rd., Kent, OH 44240 | 2020-02-07 |
| 1710526702 | Rebecca K Cibik | Pediatrics | 2497 State Route 59, Kent, OH 44240 | 2019-12-23 |
| 1073099834 | Sean Joseph Hiemstra | Case Manager/Care Coordinator | 5982 Rhodes Road Kent Ohio 44240, Kent, OH 44240 | 2018-07-16 |
| 1740798081 | Mason Brain Yoder | Counselor | 1025 Erin Drive, Kent, OH 44240 | 2018-01-22 |
| 1710405055 | Ashley Barczok | Nurse Practitioner | 5982 Rhodes Road, Kent, OH 44240 | 2017-09-07 |
| 1073963930 | Kimberly Ruth Griffith | Counselor | 190 Currie Hall Pkwy Ste A, Kent, OH 44240 | 2016-06-21 |
| 1801257456 | Ra'mone Williams | Audiologist | 717 Beryl Dr, Kent, OH 44240 | 2016-03-10 |
| 1730546615 | Christina Cole | Nurse Practitioner | 1675 E Main St Ste 328, Kent, OH 44240 | 2016-01-22 |
| Find all providers in zip 44240 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659359768 | Hai T Pham | Podiatrist | 1221 S. Water Street, Suite A, Kent, OH 44240 | 2006-01-09 |
| 1639160666 | James E Benedict | Podiatrist | 1627 E Main St, Kent, OH 44240-2875 | 2005-10-31 |
| 1316127475 | Windy Cole Dpm | Podiatrist | 1533 S Water St, Kent, OH 44240-4471 | 2007-11-06 |
| 1467631762 | Benedict Podiatry Group | Podiatrist | 1627 E Main St, Kent, OH 44240-2875 | 2007-11-02 |
| 1902013428 | Isb, Inc | Podiatrist | 10056 Se 240th St, Suite D, Kent, WA 98031-5126 | 2007-05-16 |
| 1427082551 | Jennifer M Fath | Podiatrist | 1221 S. Water Street, Suite A, Kent, OH 44240 | 2006-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013518950 | Mobile Foot Care Specialists, L.L.C. | Podiatrist | 38752 Renwood Ave, Avon, OH 44011-5229 | 2020-11-06 |
| 1275159345 | Buckeye Foot Care | Podiatrist | 5105 Som Center Rd Ste 102, Willoughby, OH 44094-4203 | 2020-06-24 |
| 1285289439 | Brent L. Rubin & Associates Inc | Podiatrist | 755 W South Boundary St, Perrysburg, OH 43551-5226 | 2019-08-05 |
| 1902467459 | Zaccardelli and Ritz | Podiatrist | 5556 Ridge Rd, Parma, OH 44129-2305 | 2019-06-25 |
| 1134786635 | Integrity Foot and Ankle Associates, LLC | Podiatrist | 1740 Cooper Foster Park Rd W Ste B, Lorain, OH 44053-4201 | 2019-05-21 |
| 1891351185 | Foot and Ankle Specialists of Central Ohio LLC | Podiatrist | 1 Healthy Place, Suite 202, Pataskala, OH 43062-7067 | 2019-05-13 |
| 1376109660 | Foot and Ankle Specialists of Central Ohio LLC | Podiatrist | 65 E Granville St, Sunbury, OH 43074-9130 | 2019-05-13 |
| 1770149296 | Foot and Ankle Specialists of Central Ohio, LLC | Podiatrist | 6002 E. Main Street, Columbus, OH 43213-3355 | 2019-05-10 |
| 1295390268 | Greenberg Foot and Ankle | Podiatrist | 1989 Miamisburg Centerville Rd Ste 200, Dayton, OH 45459-3858 | 2019-05-06 |
| 1083278287 | Kburtondpm LLC | Podiatrist | 662 Seagull Ct, Westerville, OH 43082-8534 | 2019-04-24 |
| 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.