Provider Demographics
NPI:1447011770
Name:ROSS, JAMIE M
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:M
Last Name:ROSS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:M
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4188 BRIDGEWATER PKWY APT 302
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-6111
Mailing Address - Country:US
Mailing Address - Phone:330-606-4862
Mailing Address - Fax:
Practice Address - Street 1:4188 BRIDGEWATER PKWY APT 302
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-6111
Practice Address - Country:US
Practice Address - Phone:330-606-4862
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No172A00000XOther Service ProvidersDriver
No174200000XOther Service ProvidersMeals
No253Z00000XAgenciesIn Home Supportive Care
No305S00000XManaged Care OrganizationsPoint of Service