Individual provider Active NPI

Jennifer L Odoherty, CNP

  • Women's Health Nurse Practitioner
  • Cleveland, OH
National Provider Identifier
1114017670
Registry record updated Jan 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
NP06781 Issued in OH
Practice address
2500 Metrohealth Dr
Cleveland, OH 44109-1900
Phone
(216) 778-7800
NPI assigned
Oct 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X NP06781 OH Primary

Addresses

Primary practice location

2500 Metrohealth Dr
Cleveland, OH 44109-1900

Mailing address

2500 Metrohealth Dr
Cleveland, OH 44109-1900
Phone (216) 778-7800

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
I20101011000660 OH Practitioner - Nurse Practitioner 4587856471 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

36901 American Way
Avon, OH 44011-4057
Phone (216) 444-2200

850 Columbia Rd
Suite 330
Westlake, OH 44145-7215
Phone (440) 835-3883

8950 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-8950

9500 Euclid Ave
Cleveland, OH 44195-0001

Hospital & facility affiliations

  • Cleveland Clinic Hospital, Cleveland, OH, CCN 360180
  • Fairview Hospital Hospital, Cleveland, OH, CCN 360077
  • Cleveland Clinic Avon Hospital Hospital, Avon, OH, CCN 360364

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP06781OHMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Metrohealth System CurrentSince Jan 28, 2015 Accepting new patients
The Metrohealth System CurrentSince Jan 28, 2015 Accepting new patients
The Cleveland Clinic Foundation CurrentSince Nov 27, 2017 Accepting new patients
The Metrohealth System Current Accepting new patients
The Metrohealth System Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

36901 American Way
Avon, OH 44011
Phone (440) 930-6200

2500 Metrohealth Dr
Cleveland, OH 44109
Phone (216) 778-2348

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

5172 Leavitt Rd
Lorain, OH 44053
Phone (440) 282-7420

24700 Lorain Rd
Ste 304
North Olmsted, OH 44070
Phone (440) 777-3800

850 Columbia Rd
Ste 330
Westlake, OH 44145
Phone (440) 835-3883

Interoperability endpoints

  • Direct secure messaging: jodoherty99368@direct.metrohealth.org

Organizations & group practices 6

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.

Hospital & facility affiliations 3

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421798400000",
    "number": "1114017670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 METROHEALTH DR",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441091900",
            "telephone_number": "216-778-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 METROHEALTH DR",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441091900",
            "telephone_number": "216-778-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODOHERTY",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2015-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "OH",
            "license": "NP06781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.