Healthcare Provider Details

I. General information

NPI: 1053231738
Provider Name (Legal Business Name): JODI ARTH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27895 LINCOLN RD
BAY VILLAGE OH
44140-2104
US

IV. Provider business mailing address

27895 LINCOLN RD
BAY VILLAGE OH
44140-2104
US

V. Phone/Fax

Practice location:
  • Phone: 440-668-0070
  • Fax:
Mailing address:
  • Phone: 440-668-0070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberLE-00064360
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: