NPIMap

Individual provider Active NPI

Jodi Lynne Van Jura, M.D.

  • Family Medicine Physician
  • Miamisburg, OH
National Provider Identifier
1023122157
Registry record updated Nov 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35.079730 Issued in OH
Practice address
4000 Miamisburg Centerville Rd
Suite 410
Miamisburg, OH 45342-7615
Phone
(937) 384-8773
Fax
(937) 384-0794
NPI assigned
Aug 18, 2006
Last updated
Nov 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X 35079730 OH
Family Medicine Physician 207Q00000X 35.079730 OH Primary

Addresses

Primary practice location

4000 Miamisburg Centerville Rd
Suite 410
Miamisburg, OH 45342-7615

Mailing address

4000 Miamisburg Centerville Rd Ste 410
Miamisburg, OH 45342-3758
Phone (937) 384-8773

Other identifiers 1

IdentifierTypeStateIssuer
2350950MedicaidOH

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jvanjura19652@direct.khnetwork.org
FHIR URL https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080327000513 OH Practitioner - Family Practice 3870679004 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wright State University Boonshoft School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oxford Physical Therapy and RehabilitationGroup PAC ID 0244232874, 432 clinicians

Practice addresses (Care Compare)

1507 Springfield Pike
Cincinnati, OH 45215-1437
Phone (513) 821-3700

7567 Central Parke Blvd
A
Mason, OH 45040-6852

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35.079730OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jodi Van Jura MD, Inc CurrentSince Jul 1, 2022 Accepting new patients

Locations

1507 Springfield Pike
Cincinnati, OH 45215
Phone (513) 821-6500

Interoperability endpoints

  • Direct secure messaging: jodi.van.jura.1@15727.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668556800000",
    "number": "1023122157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 MIAMISBURG CENTERVILLE RD STE 410",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453423758",
            "telephone_number": "937-384-8773",
            "fax_number": "937-384-0794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 MIAMISBURG CENTERVILLE RD",
            "address_2": "SUITE 410",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453427615",
            "telephone_number": "937-384-8773",
            "fax_number": "937-384-0794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN JURA",
        "first_name": "JODI",
        "middle_name": "LYNNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "OH",
            "license": "35079730",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.079730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2350950",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jvanjura19652@direct.khnetwork.org",
            "affiliation": "N",
            "address_1": "4000 Miamisburg Centerville Rd",
            "address_2": "Suite 410",
            "city": "Miamisburg",
            "state": "OH",
            "country_code": "US",
            "postal_code": "453427615",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "4000 Miamisburg Centerville Rd",
            "address_2": "Suite 410",
            "city": "Miamisburg",
            "state": "OH",
            "country_code": "US",
            "postal_code": "453427615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Miamisburg, OH

Sources for this page

Verify at the official NPI Registry.