Individual provider Active NPI

Jessica Lynne Quesenberry, APRN

  • Family Nurse Practitioner
  • Springfield, OH
National Provider Identifier
1063769826
Registry record updated Aug 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.024882 Issued in OH
Practice address
2355 Derr Rd
Springfield, OH 45503-2439
Phone
(937) 629-0100
NPI assigned
Aug 12, 2012
Last updated
Aug 6, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 353847 OH
Family Nurse Practitioner 363LF0000X APRN.CNP.024882 OH Primary

Addresses

Primary practice location

2355 Derr Rd
Springfield, OH 45503-2439

Mailing address

2355 Derr Rd Ste a
Springfield, OH 45503-2439
Phone (937) 629-0100

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
I20190827004190 OH Practitioner - Nurse Practitioner 9032447115 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Wright State University Boonshoft School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pulmonary and Critical Care Consultants, IncGroup PAC ID 9234115379, 34 clinicians

Practice addresses (Care Compare)

1520 S Main St
Suite 2
Dayton, OH 45409-2643
Phone (937) 461-5815

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
353847OHMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Pulmonary & Critical Care Consultants, Inc CurrentSince Mar 1, 2020 Accepting new patients
Gcga Physicians Inc. PastSince Aug 1, 2019 Accepting new patients

Locations

1520 S Main St
Ste 2
Dayton, OH 45409
Phone (937) 461-5815

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ICEACA/Endpoint/ICEACA
  • Direct secure messaging: jessica.quesenberry@pulmcare.eclinicaldirectplus.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 2

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": "1344729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565049600000",
    "number": "1063769826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2355 DERR RD STE A",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455032439",
            "telephone_number": "937-629-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2355 DERR RD",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455032439",
            "telephone_number": "937-629-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUESENBERRY",
        "first_name": "JESSICA",
        "middle_name": "LYNNE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-12",
        "last_updated": "2019-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "353847",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.024882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OH

Sources for this page

Verify at the official NPI Registry.