Individual provider Active NPI

Jamie Leeann Kenney, CNP

  • Family Nurse Practitioner
  • Cleveland, OH
National Provider Identifier
1053831578
Registry record updated Dec 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.020980 Issued in OH
Practice address
3820 Superior Ave E Ste 214
Cleveland, OH 44114-4169
Phone
(330) 535-3263
NPI assigned
Jun 26, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2017

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.020980 OH Primary

Addresses

Primary practice location

3820 Superior Ave E Ste 214
Cleveland, OH 44114-4169

Mailing address

730 Carroll St
Akron, OH 44304-1934

Other names 1

  • Jamie Leeann Miller Former name

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
I20180108002801 OH Practitioner - Nurse Practitioner 5698034197 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN.CNP.020980OHMDFamily Nurse Practitioner

Organizations & group practices 1

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": "1498435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512518400000",
    "number": "1053831578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 CARROLL ST",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443041934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3820 SUPERIOR AVE E STE 214",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441144169",
            "telephone_number": "330-535-3263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEY",
        "first_name": "JAMIE",
        "middle_name": "LEEANN",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-26",
        "last_updated": "2017-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.020980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAMIE",
            "last_name": "MILLER",
            "middle_name": "LEEANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.