Individual provider Active NPI

Jessica Lynn Hack, FNP

  • Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1114528171
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN.CNP.0027571 Issued in OH
Practice address
111 S Grant Ave
Columbus, OH 43215-1898
Phone
(614) 566-5000
NPI assigned
Nov 5, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN.CNP.0027571 OH Primary

Addresses

Primary practice location

111 S Grant Ave
Columbus, OH 43215-1898

Mailing address

5450 Frantz Rd Ste 360
Dublin, OH 43016-4141

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
I20201211002494 OH Practitioner - Nurse Practitioner 4688086895 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marion Area Physicians LLCGroup PAC ID 1850549437, 179 clinicians

Practice addresses (Care Compare)

1050 Delaware Ave
Marion, OH 43302-6416
Phone (740) 383-7936

Hospital & facility affiliations

  • Marion General Hospital Hospital, Marion, OH, CCN 360011

Merit-based Incentive Payment System (MIPS)

Final score
85.5 of 100Reported as apm
Quality
71.52
Promoting interoperability
95.57
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0027571OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation CurrentSince Nov 10, 2020 Accepting new patients
Ohiohealth Corporation Current Accepting new patients
Marion Area Physicians LLC CurrentSince Oct 1, 2021 Accepting new patients
Ohiohealth Corporation CurrentSince Nov 10, 2020 Accepting new patients

Locations

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

Dept L3652
Columbus, OH 43260

111 S Grant Ave
Columbus, OH 43215
Phone (614) 461-3232

5450 Frantz Rd
Ste 360
Dublin, OH 43016
Phone (614) 533-6497

1040 Delaware Ave
Marion, OH 43302
Phone (330) 256-9874

1050 Delaware Ave
Marion, OH 43302
Phone (740) 383-7038

Organizations & group practices 4

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 2

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": "1604534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1114528171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 FRANTZ RD STE 360",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430164141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S GRANT AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432151898",
            "telephone_number": "614-566-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACK",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-05",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.0027571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.