Jessica Marie Sanford, CNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

71008628A Issued in IN

Practice address

11500 Northlake Dr
Cincinnati, OH 45249-1650

Phone

(513) 742-6310

NPI assigned

Dec 19, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Jessica Maire Bolton Former name

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

Merit-based Incentive Payment System (MIPS)

Final score

88.71 of 100Reported as group

Quality

83.07

Promoting interoperability

100

Improvement activities

40

Cost

79.29

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Crossroads Hospice of Cincinnati

  • Community Based Hospice Care Agency
  • Cincinnati, OH
  • NPI 1285673111

  OH

  Medicare reassignment NPD
• The Christ Hospital Medical Associates, LLC

  • Internal Medicine Physician
  • Cincinnati, OH
  • NPI 1114107919

  Family

  NPD
• Extended Care Specialists, Inc

  • Family Medicine Physician
  • Fort Wayne, IN
  • NPI 1669873733
  NPD
• Skilled Care Pharmacy,LLC

  • Durable Medical Equipment & Medical Supplies
  • Mason, OH
  • NPI 1437324522
  NPD (past)

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

{
    "created_epoch": "1545177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678579200000",
    "number": "1104398833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6557 STONELAKE WAY",
            "city": "FAIRFIELD TOWNSHIP",
            "state": "OH",
            "postal_code": "450118160",
            "telephone_number": "513-828-1578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11500 NORTHLAKE DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452491650",
            "telephone_number": "513-742-6310"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "36 Valley Dr",
            "address_purpose": "LOCATION",
            "city": "Lawrenceburg",
            "state": "IN",
            "postal_code": "470251084",
            "country_code": "US",
            "telephone_number": "812-537-0930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANFORD",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-19",
        "last_updated": "2023-03-12",
        "certification_date": "2022-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71008628A",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OH",
            "license": "CNP.020779",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IN",
            "license": "71008628A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "APRN.CNP.020779",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "BOLTON",
            "middle_name": "MAIRE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joshua J Sands, MD
• Kimberlee Sandusky, RN, PHN II
• Susan Marie Sandwall, LISW-S
• Saneta Smith
• Jeremy Sanford
• Kimberly Sangare
• Kiranpal Singh Sangha
• Isaac Olatunde Sangodele, RN
• Theophilus Akinola Sangodele
• Zeinab Sani Ellis, CNP

• All providers in Cincinnati, OH
• Adult Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.