Individual provider Active NPI

Jennifer Teresa Sprague

  • Physician Assistant
  • Montgomery, OH
National Provider Identifier
1033628268
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.005482RX Issued in OH
Practice address
10506 Montgomery Rd Ste 200a
Montgomery, OH 45242-4400
Phone
(513) 865-9916
Fax
(513) 246-2343
NPI assigned
Sep 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.005482RX OH Primary
Physician Assistant 363A00000X TC639 KY

Addresses

Primary practice location

10506 Montgomery Rd Ste 200a
Montgomery, OH 45242-4400

Mailing address

2300 Chamber Center Dr
Lakeside Park, KY 41017-1686
Phone (859) 301-4723

Other practice location 1

20 Medical Village Dr
Edgewood, KY 41017-5401
Phone (859) 301-4723

Other identifiers 1

IdentifierTypeStateIssuer
2565399MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20171017002126 KY Practitioner - Physician Assistant 1254607344 Reassigns benefits to 1 organization
I20180405002043 OH Practitioner - Physician Assistant 1254607344 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Trihealth H LLCGroup PAC ID 1850570458, 850 clinicians

Practice addresses (Care Compare)

10500 Montgomery Rd
Montgomery, OH 45242-4402
Phone (513) 246-2400

10506 A Montgomery Rd
Montgomery, OH 45242-4402

3219 Clifton Ave
Suite 400
Cincinnati, OH 45220-3049
Phone (513) 246-2400

375 Dixmyth Ave
Cincinnati, OH 45220-2475

379 Dixmyth Ave
Cincinnati, OH 45220-2475
Phone (513) 246-7000

Hospital & facility affiliations

  • Bethesda North Hospital, Cincinnati, OH, CCN 360179
  • Good Samaritan Hospital Hospital, Cincinnati, OH, CCN 360134

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
TC639KYMDPhysician Assistant
50.005482RXOHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Elizabeth Medical Center, Inc CurrentSince Oct 16, 2017 Accepting new patients
Trihealth G LLC Physician Assistant CurrentSince Sep 13, 2021 Accepting new patients
Trihealth H LLC Physician Assistant CurrentSince Nov 3, 2022 Accepting new patients
St. Elizabeth Medical Center, Inc. Physician Assistant CurrentSince Oct 16, 2017 Accepting new patients
Trihealth G, LLC CurrentSince Sep 13, 2021 Accepting new patients
Hospice of Cincinnati Incorporated PastSince Sep 23, 2021 Accepting new patients
Trihealth Physician Institute Physician Assistant Past Accepting new patients

Locations

20 Medical Village Dr
Ste 204
Edgewood, KY 41017
Phone (859) 301-5959

20 Medical Village Dr
Edgewood, KY 41017
Phone (859) 344-1600

1 Medical Village Dr
Edgewood, KY 41017
Phone (859) 301-2000

375 Dixmyth Ave
Cincinnati, OH 45220
Phone (513) 862-2432

2001 Anderson Ferry Rd
Cincinnati, OH 45238
Phone (513) 922-1200

3219 Clifton Ave
Ste 400A
Cincinnati, OH 45220
Phone (513) 246-2535

375 Dixmyth Ave
Ste 3135
Cincinnati, OH 45220
Phone (513) 862-3452

10506 Montgomery Rd
Ste 200A
Montgomery, OH 45242
Phone (513) 246-2343

10500 Montgomery Rd
Montgomery, OH 45242
Phone (513) 557-3206

Interoperability endpoints

  • Direct secure messaging: jsprague247035@direct.trihealth.com

Organizations & group practices 9

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.

Hospital & facility affiliations 6

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": "1505865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1033628268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 CHAMBER CENTER DR",
            "city": "LAKESIDE PARK",
            "state": "KY",
            "postal_code": "410171686",
            "telephone_number": "859-301-4723",
            "fax_number": "859-301-4724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10506 MONTGOMERY RD STE 200A",
            "city": "MONTGOMERY",
            "state": "OH",
            "postal_code": "452424400",
            "telephone_number": "513-865-9916",
            "fax_number": "513-246-2343"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 Medical Village Dr",
            "address_purpose": "LOCATION",
            "city": "Edgewood",
            "state": "KY",
            "postal_code": "410175401",
            "country_code": "US",
            "telephone_number": "859-301-4723",
            "fax_number": "859-301-4724",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPRAGUE",
        "first_name": "JENNIFER",
        "middle_name": "TERESA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-20",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.005482RX",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "TC639",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2565399",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, OH

Sources for this page

Verify at the official NPI Registry.