Jenna J Branam, CNP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Sidney, OH
NPI 1083229751 · NPPES record last updated Aug 15, 2024
Key facts
- NPI
- 1083229751
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- APRN.CNP.0028292 (OH)
- Practice address
- 1101 N Vandemark Rd
Sidney, OH 45365-3567 - Phone
- (937) 622-7393
- Fax
- (937) 667-5002
- NPI assigned
- Sep 10, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Darke County Recovery Services
South Community Inc.
Practice addresses (Care Compare)
1101 N Vandemark Rd
Sidney, OH 45365-3567
Phone (937) 548-6842
3095 Kettering Blvd
Moraine, OH 45439-1983
Phone (937) 293-8300
Hospital & facility affiliations
- Wilson Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210414000162 | OH | Practitioner - Nurse Practitioner | 2466860366 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN.422570 | OH | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Samaritan Behavioral Health, Inc. | Current | Accepting new patients | |
| South Community Inc. | Current |
Accepting new patients | |
| Samaritan Behavioral Health, Inc. | Current |
Accepting new patients | |
| Darke County Recovery Services | Current |
Accepting new patients | |
| South Community Inc | Current |
Accepting new patients | |
| Samaritan Behavioral Health, Inc. | Current |
Accepting new patients |
Locations
601 S Edwin C Moses Blvd
Fl 4
Dayton, OH 45417
Phone (937) 734-8333
601 S Edwin C Moses Blvd
Dayton, OH 45417
Phone (937) 734-4310
600 Walnut St
Greenville, OH 45331
Phone (937) 335-0361
212 E Main St
Greenville, OH 45331
Phone (937) 423-6344
3095 Kettering Blvd
Moraine, OH 45439
1101 N Vandemark Rd
Sidney, OH 45365
Phone (937) 492-8080
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/recoveryandwellnessohio/r4/
- https://api.qualifacts.org/api/fhir/sbhihelp/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN.422570 | OH | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | APRN.CNP.0028292 | OH | Yes |
Addresses
Primary practice location
1101 N Vandemark Rd
Sidney, OH 45365-3567
Mailing address
1101 N Vandemark Rd
Sidney, OH 45365-3567
Phone (937) 622-7393
Other practice location 1
3095 Kettering Blvd
Moraine, OH 45439-1983
Phone (937) 293-8300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0435665 | Medicaid | OH |
Other providers in Sidney, OH
- Carol Bornhorst
- Kenneth Bosslet
- Stacy Bowen
- Maria Boyden
- Chrissi Brammer
- Kimberly Brandyberry
- Jessica Breeding
- Jane E Brewer-Kuhlman
- Lori Lyn Brown
- Randy Brown
All providers in Sidney, OH · Psychiatric/Mental Health Nurse Practitioner in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 15, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.