MEDICARE: JADA CLENDENIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	50.010147RX	OH

General Provider Information

NPI Number	:	1528924347
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JADA CLENDENIN

Provider Business Mailing Address
First Line	:	PO BOX 80690
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44708-0690
Country	:	US
Telephone Number	:	330-363-7444
Fax Number	:	330-363-7770

Provider Business Practice Location Address
First Line	:	4650 HILLS AND DALES RD NW
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44708-6220
Country	:	US
Telephone Number	:	330-491-9675
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/26/2025
Last Update Date	:	03/15/2026

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Directions to “ JADA CLENDENIN ” Practice Location

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