Individual provider Active NPI

Jonathan Chandler Frederick, CNP

  • Family Nurse Practitioner
  • Tiffin, OH
National Provider Identifier
1093569972
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.0036432 Issued in OH
Practice address
1344 W Seneca Ave
Tiffin, OH 44883-2652
Phone
(419) 455-8140
Fax
(419) 225-8878
NPI assigned
Apr 16, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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 APRN.CNP.0036432 OH Primary

Addresses

Primary practice location

1344 W Seneca Ave
Tiffin, OH 44883-2652

Mailing address

329 N West St
Lima, OH 45801-4332
Phone (419) 221-3072

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
I20240528002351 OH Practitioner - Nurse Practitioner 7517309164 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health Partners of Western Ohio 56 clinicians

Practice addresses (Care Compare)

1344 W Seneca Ave
Tiffin, OH 44883-2652
Phone (419) 455-8140

Hospital & facility affiliations

  • Mercy Health - Tiffin Hospital Hospital, Tiffin, OH, CCN 360089

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Incare Health Solutions, LLC Family CurrentSince May 14, 2024 Accepting new patients
Health Partners of Western Ohio CurrentSince Nov 12, 2024 Accepting new patients
Incare Health Solutions LLC CurrentSince May 14, 2024 Accepting new patients
Health Partners of Western Ohio CurrentSince Nov 12, 2024 Accepting new patients
Health Partners of Western Ohio Current Accepting new patients
Health Partners of Western Ohio Past Accepting new patients
Health Partners of Western Ohio Past Accepting new patients

Locations

1085 Polaris Pkwy
Columbus, OH 43240
Phone (614) 505-0021

1 Spartan Way
Lima, OH 45801
Phone (419) 222-3546

329 N West St
Lima, OH 45801
Phone (419) 229-6007

7450 State Route 161 E
Plain City, OH 43064
Phone (614) 504-5002

1344 W Seneca Ave
Tiffin, OH 44883
Phone (419) 447-6900

2562 W Market St
Tiffin, OH 44883
Phone (567) 938-8008

Organizations & group practices 24

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.

View all 24

Hospital & facility affiliations 1

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": "1713225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1093569972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 N WEST ST",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458014332",
            "telephone_number": "419-221-3072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1344 W SENECA AVE",
            "city": "TIFFIN",
            "state": "OH",
            "postal_code": "448832652",
            "telephone_number": "419-455-8140",
            "fax_number": "419-225-8878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "JONATHAN",
        "middle_name": "CHANDLER",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-16",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0036432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tiffin, OH

Sources for this page

Verify at the official NPI Registry.