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J K VAN ETTEN NPI 1114421344


NPI Information

NPI: 1114421344
Provider Name: J K VAN ETTEN
Classification: Emergency Medicine - 207PE0004X
Entity Type: Individual

Specialization: Emergency Medical Services

PECOS Registration: Yes

Address:
2500 METROHEALTH DR
CLEVELAND, OH
ZIP 44109
Phone: (216) 778-4486
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J K Van Etten is an emergency medical services emergency medicine in Cleveland, OH with 6 years of experience. The provider is an emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. J K Van Etten NPI is 1114421344. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: CLVLND CLINIC LERNER COLLEGE OF MED OF CASE WSTN RSV UNIVERSITY
Graduation Year:2018

The provider's business location address is:

2500 METROHEALTH DR
CLEVELAND, OH
ZIP 44109-900
Phone: (216) 778-4486

The NPI 1114421344 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/21/2018 and was last updated on 12/21/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207PE0004XEmergency MedicineEmergency Medical ServicesMD61136032WASHINGTONYes
2390200000XStudent in an Organized Health Care Education/Training ProgramNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.