Jennifer R O'Bryan, CDE, RN

Primary specialty

Diabetes Educator Registered NurseTaxonomy code 163WD0400X

License

1087693 Issued in KY

Practice address

2195 Harrodsburg Rd Ste 125
Lexington, KY 40504-3543

Phone

(859) 323-2232

Fax

(859) 257-1078

NPI assigned

Jul 20, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Jennifer Renee Reisz Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1279584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1093028037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 950202",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402950202",
            "telephone_number": "502-272-5100",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2195 HARRODSBURG RD STE 125",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405043543",
            "telephone_number": "859-323-2232",
            "fax_number": "859-257-1078"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4001 Dutchmans Ln",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402074714",
            "country_code": "US",
            "telephone_number": "502-899-6907",
            "fax_number": "502-899-6905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'BRYAN",
        "first_name": "JENNIFER",
        "middle_name": "R",
        "credential": "CDE, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-20",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "KY",
            "license": "129923",
            "primary": false
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "KY",
            "license": "1087693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA - NMFMS",
            "identifier": "000057043X",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA - NMFMS",
            "identifier": "8905818",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM - NMFMS",
            "identifier": "000000683678",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "REISZ",
            "middle_name": "RENEE",
            "credential": "RN, CDE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Paula K O'Bannon, CRNA
• Turner Jo'Steven O'Brian, DMD
• Carol M O'Brien, CSW, MSW
• John M O'Brien, MD
• Morgan O'Brien, MS, BCBA, LBA
• Karissa O'Bryan
• John Charles O'Connell, M.D.
• Christina Lee O'Connor, CRNA
• Kevin F O'Connor Jr., M.D.
• Mary Evelyn O'Daniel-Pierce, M.D.

• All providers in Lexington, KY
• Diabetes Educator Registered Nurse in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2024; 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.