Individual provider Active NPI

L Candace Jennings, M.D.

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Dublin, OH
National Provider Identifier
1083768154
Registry record updated Apr 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
License
35.120973 Issued in OH
Practice address
4019 W Dublin Granville Rd
Dublin, OH 43017-1436
Phone
(614) 293-2957
Fax
(614) 688-3700
NPI assigned
Jan 23, 2007
Last updated
Apr 18, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 59514 MA
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 35.120973 OH Primary

Addresses

Primary practice location

4019 W Dublin Granville Rd
Dublin, OH 43017-1436

Mailing address

453 W 10TH Ave
Columbus, OH 43210-2205
Phone (614) 293-2957

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35.120973OHMDHospice and Palliative Medicine (Internal Medicine) Physician
59514MAMDOrthopaedic Surgery Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366243200000",
    "number": "1083768154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "453 W 10TH AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432102205",
            "telephone_number": "614-293-2957",
            "fax_number": "614-688-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4019 W DUBLIN GRANVILLE RD",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430171436",
            "telephone_number": "614-293-2957",
            "fax_number": "614-688-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "L CANDACE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2013-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MA",
            "license": "59514",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "OH",
            "license": "35.120973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.