Individual provider Active NPI

Jamie Lynn Pearson, NP-C

  • Family Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1023592912
Registry record updated Jan 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.023428 Issued in OH
Practice address
5801 Tamarack Blvd
Columbus, OH 43229-3747
Phone
(614) 436-6009
NPI assigned
Sep 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.023428 OH Primary

Addresses

Primary practice location

5801 Tamarack Blvd
Columbus, OH 43229-3747

Mailing address

200 Kienle Dr
Piqua, OH 45356-4120
Phone (937) 339-5355

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/
Direct Messaging Address jpearson716140@direct.ketteringhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181126003729 OH Practitioner - Nurse Practitioner 8820342181 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN.CNP.023428OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Incare Health Solutions, LLC Family CurrentSince Oct 1, 2018 Accepting new patients
Incare Health Solutions LLC CurrentSince Oct 1, 2018 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

5801 Tamarack Blvd
Columbus, OH 43229
Phone (614) 436-6009

7450 State Route 161 E
Plain City, OH 43064
Phone (614) 504-5002

2562 W Market St
Tiffin, OH 44883
Phone (567) 938-8008

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1537228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609804800000",
    "number": "1023592912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 KIENLE DR",
            "city": "PIQUA",
            "state": "OH",
            "postal_code": "453564120",
            "telephone_number": "937-339-5355",
            "fax_number": "937-773-3980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 TAMARACK BLVD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432293747",
            "telephone_number": "614-436-6009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "JAMIE",
        "middle_name": "LYNN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-18",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.023428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "200 Kienle Dr",
            "city": "Piqua",
            "state": "OH",
            "country_code": "US",
            "postal_code": "453564120",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jpearson716140@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "200 Kienle Dr",
            "city": "Piqua",
            "state": "OH",
            "country_code": "US",
            "postal_code": "453564120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.