Provider Demographics
NPI:1790135515
Name:SAPORITA, JAMIE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:
Last Name:SAPORITA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:JAMIE
Other - Middle Name:
Other - Last Name:WELCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:25950 DIXIE HWY STE 400
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-2983
Mailing Address - Country:US
Mailing Address - Phone:567-585-0010
Mailing Address - Fax:567-225-3490
Practice Address - Street 1:25950 DIXIE HWY STE 400
Practice Address - Street 2:
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-2983
Practice Address - Country:US
Practice Address - Phone:567-585-0010
Practice Address - Fax:567-225-3490
Is Sole Proprietor?:No
Enumeration Date:2016-06-14
Last Update Date:2019-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.004678RX363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1132742OtherNCCPA CERTIFICATION