Individual provider Active NPI

Jamie Kennedy

  • Family Nurse Practitioner
  • Springfield, OH
National Provider Identifier
1124530126
Registry record updated Dec 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.021877 Issued in OH
Practice address
1343 N Fountain Blvd Ste 250
Springfield, OH 45504-1479
Phone
(937) 523-9050
NPI assigned
Oct 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2017

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.021877 OH Primary

Addresses

Primary practice location

1343 N Fountain Blvd Ste 250
Springfield, OH 45504-1479

Mailing address

6545 State Route 201
Tipp City, OH 45371-8799
Phone (937) 663-0138

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
I20171121002581 OH Practitioner - Nurse Practitioner 0840557146 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Physicians Springfield Primary Care LLCGroup PAC ID 7315361359, 37 clinicians

Practice addresses (Care Compare)

160 S Tuttle Rd
Springfield, OH 45505-1553
Phone (937) 523-9690

Hospital & facility affiliations

  • Springfield Regional Medical Center Hospital, Springfield, OH, CCN 360086
  • Mercy Health - West Hospital Hospital, Cincinnati, OH, CCN 360234

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Springfield Specialty Care LLC CurrentSince Jan 1, 2021 Accepting new patients
Mercy Health Physicians Springfield Primary Care LLC CurrentSince Sep 1, 2020 Accepting new patients
Community Mercy Health Partners Past Accepting new patients

Locations

160 S Tuttle Rd
Springfield, OH 45505
Phone (937) 523-9690

211 Northparke Dr
Springfield, OH 45503
Phone (937) 390-1700

1343 N Fountain Blvd
Ste 250
Springfield, OH 45504
Phone (937) 328-8700

30 W McCreight Ave
Ste 110
Springfield, OH 45504
Phone (937) 399-2142

900 Scioto St
Ste 4
Urbana, OH 43078
Phone (937) 653-4666

900 Scioto St
Ste 1
Urbana, OH 43078
Phone (937) 653-4666

Interoperability endpoints

  • Direct secure messaging: jkennedy49273@direct.bsmhealth.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.

Hospital & facility affiliations 4

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": "1509321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513296000000",
    "number": "1124530126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6545 STATE ROUTE 201",
            "city": "TIPP CITY",
            "state": "OH",
            "postal_code": "453718799",
            "telephone_number": "937-663-0138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1343 N FOUNTAIN BLVD STE 250",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455041479",
            "telephone_number": "937-523-9050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "JAMIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-30",
        "last_updated": "2017-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.021877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OH

Sources for this page

Verify at the official NPI Registry.