Individual provider Active NPI

Jessica Lynn Lorenzo, FNP

  • Family Nurse Practitioner
  • Coshocton, OH
National Provider Identifier
1073972279
Registry record updated Mar 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
18484 Issued in OH
Practice address
1523 Walnut St
Suite 1
Coshocton, OH 43812-2289
Phone
(740) 622-3016
NPI assigned
Feb 16, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 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 18484 OH Primary

Addresses

Primary practice location

1523 Walnut St
Suite 1
Coshocton, OH 43812-2289

Mailing address

340 Oxford St
Suite 1
Dover, OH 44622-1965
Phone (740) 622-3016

Other identifiers 2

IdentifierTypeStateIssuer
0161967MedicaidOH
H447140OtherOHMEDICARE PTAN

Other names 1

  • Jessica Lynn Moore 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
I20160415001476 OH Practitioner - Nurse Practitioner 2567760002 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Union Physician Services LLCGroup PAC ID 0143366591, 97 clinicians
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

110 Dublin Dr
Dover, OH 44622-7805
Phone (330) 364-9088

9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-2200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18484OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Union Physician Services, LLC CurrentSince Jul 1, 2020 Accepting new patients
The Union Hospital Association CurrentSince Apr 1, 2017 Accepting new patients
The Cleveland Clinic Foundation CurrentSince Oct 15, 2025 Accepting new patients
The Union Hospital Association CurrentSince Apr 1, 2017 Accepting new patients

Locations

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

659 Boulevard St
Dover, OH 44622
Phone (330) 343-3311

110 Dublin Dr
Dover, OH 44622
Phone (330) 343-0753

205 Hospital Dr
Dover, OH 44622
Phone (330) 343-3335

110 Dublin Dr
#A
Dover, OH 44622
Phone (330) 364-8038

110 Dublin Dr
#B
Dover, OH 44622
Phone (330) 343-0753

Organizations & group practices 4

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 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": "1455580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488758400000",
    "number": "1073972279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 OXFORD ST",
            "address_2": "SUITE 1",
            "city": "DOVER",
            "state": "OH",
            "postal_code": "446221965",
            "telephone_number": "740-622-3016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1523 WALNUT ST",
            "address_2": "SUITE 1",
            "city": "COSHOCTON",
            "state": "OH",
            "postal_code": "438122289",
            "telephone_number": "740-622-3016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LORENZO",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-16",
        "last_updated": "2017-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "18484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0161967",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "H447140",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "MOORE",
            "middle_name": "LYNN",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Coshocton, OH

Sources for this page

Verify at the official NPI Registry.