ADMIRAL MEDICAL MANAGEMENT GROUP LLC
NPI 1407357742
Clinic/Center - Multi-Specialty in Cleveland, OH

Active since February 22, 2018CLIA 36D2311005 · Waiver
11201 SHAKER BLVD UNIT 201, CLEVELAND, OH 44104(216) 855-7775 Get Directions Write a Review

NPPES record last updated: September 17, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 17, 2024, Feb 22, 2018 (2 updates tracked since 2018).

About Admiral Medical Management Group Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ADMIRAL MEDICAL MANAGEMENT GROUP LLC (NPI 1407357742) is a healthcare organization registered as a multi-specialty in Cleveland, Ohio and active in the NPI registry since February 2018. The organization holds a CLIA Waiver certificate valid through September 15, 2026 and lists Ketura Jackson, Aprn Cnp, as its authorized official.

NPPES Registry Identity

NPI1407357742
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NameADMIRAL MEDICAL MANAGEMENT GROUP LLC
Location Address11201 SHAKER BLVD UNIT 201Cleveland, OH 44104-3869
Mailing Address11201 Shaker Blvd Unit 201Cleveland, OH 44104-3869 · (216) 855-7775
Organization SubpartNo
Authorized OfficialKetura JacksonAprn Cnp · (216) 855-7775
Enumeration DateFebruary 22, 2018
Last NPPES UpdateSeptember 17, 20242 updates tracked since enumeration
NPPES CertifiedSeptember 17, 2024
NPI 1407357742 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
Also ListedRegistered Nurse · AdministratorTaxonomy 163WA2000X · License 366986 (OH)
Also ListedClinic/CenterTaxonomy 261Q00000X
Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X
11201 SHAKER BLVD UNIT 201, Cleveland, OH 44104

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 36D2311005

Admiral Medical Management Group · Cleveland, OH
Active · expires Sep 15, 2026
CLIA Number36D2311005
Laboratory TypePractitioner Other
Certificate Effective DateSeptember 16, 2024
Certificate Expiration DateSeptember 15, 2026
Laboratory DirectorKetura Jackson
Laboratory Phone(216) 230-2046
Laboratory LocationAdmiral Medical Management Group11201 Shaker Blvd, Suite 201, Cleveland, OH 44104
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Admiral Medical Management Group LLC's NPI number?

The NPI number for Admiral Medical Management Group LLC is 1407357742. It was assigned to this organization in the NPPES registry on February 22, 2018.

Where is Admiral Medical Management Group LLC located?

Admiral Medical Management Group LLC is located at 11201 Shaker Blvd Unit 201, Cleveland, OH 44104. The listed phone number is (216) 855-7775.

What is Admiral Medical Management Group LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Does Admiral Medical Management Group LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 36D2311005) is associated with this NPI, valid through September 15, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Admiral Medical Management Group LLC accept?

Health plans from CareSource list Admiral Medical Management Group LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Admiral Medical Management Group LLC was last updated on September 17, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.