Individual provider Active NPI

Lisa Robinson Jasin, RNC, MSN, NNP

  • Critical Care Neonatal Nurse Practitioner
  • Dayton, OH
National Provider Identifier
1124169172
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Neonatal Nurse PractitionerTaxonomy code 363LN0005X
License
APRN.CNP.09174 Issued in OH
Practice address
1 Childrens PLZ
Dayton, OH 45404-1898
Phone
(937) 641-3040
NPI assigned
Feb 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Neonatal Nurse Practitioner 363LN0005X APRN.CNP.09174 OH Primary

Addresses

Primary practice location

1 Childrens PLZ
Dayton, OH 45404-1898

Mailing address

PO Box 933432
Cleveland, OH 44193-0039
Phone (937) 641-5072

Other identifiers 1

IdentifierTypeStateIssuer
0124424MedicaidOH

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
I20241021004301 OH Practitioner - Nurse Practitioner 9739611336 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
APRN.CNP.09174OHMDCritical Care Neonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Physicians Inc Current Accepting new patients
Dayton Children'S Specialty Physicians, Inc. CurrentSince Sep 1, 2024 Accepting new patients
Dayton Children'S Specialty Physicians, Inc. CurrentSince Sep 1, 2024 Accepting new patients
Shelby County Memorial Hospital Association Inc. Past Accepting new patients

Locations

1 Childrens Plz
Dayton, OH 45404
Phone (937) 641-3600

967 Bellefontaine Ave
Lima, OH 45804
Phone (419) 224-1330

915 Michigan St
Sidney, OH 45365
Phone (937) 498-2311

Interoperability endpoints

  • Direct secure messaging: ljasin668562@direct.ketteringhealth.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1124169172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 933432",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930039",
            "telephone_number": "937-641-5072",
            "fax_number": "937-641-6129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PLZ",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454041898",
            "telephone_number": "937-641-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JASIN",
        "first_name": "LISA",
        "middle_name": "ROBINSON",
        "credential": "RNC, MSN, NNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "OH",
            "license": "APRN.CNP.09174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0124424",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.