Individual provider Active NPI

Jennifer Liang Heidrich, DO

  • Family Medicine Physician
  • Dayton, OH
National Provider Identifier
1154828069
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34.015883 Issued in OH
Practice address
2261 Philadelphia Dr Ste 301
Dayton, OH 45406
Phone
(937) 734-4141
Fax
(937) 277-7249
NPI assigned
Apr 7, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34.015883 OH Primary

Addresses

Primary practice location

2261 Philadelphia Dr Ste 301
Dayton, OH 45406

Mailing address

2261 Philadelphia Dr Ste 300
Dayton, OH 45406-1814
Phone (937) 734-4141

Other names 1

  • Jennifer Liang Hemstreet Former name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230714003207 OH Practitioner - Family Practice 8527315191 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mvhe IncGroup PAC ID 9537066584, 399 clinicians

Practice addresses (Care Compare)

3080 Ackerman Blvd
Suite 110
Kettering, OH 45429-3561
Phone (937) 293-5080

Hospital & facility affiliations

  • Kettering Homecare Home health agency, Kettering, OH, CCN 367778
  • Bethany Village Home Health Care Home health agency, Dayton, OH, CCN 368343
  • Fidelity Health Care Home health agency, Moraine, OH, CCN 367160
  • Miami Valley Hospital Hospital, Dayton, OH, CCN 360051
  • Kettering Health Main Campus Hospital, Kettering, OH, CCN 360079
  • Atrium Medical Center Hospital, Franklin, OH, CCN 360076

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
34.015883OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mvhe Inc Family Medicine Current Accepting new patients
Mvhe Inc CurrentSince Sep 16, 2024 Accepting new patients
Mvhe Inc CurrentSince Sep 16, 2024 Accepting new patients

Locations

722 N Fairfield Rd
Beavercreek, OH 45434
Phone (937) 208-7000

2451 Wayne Ave
Dayton, OH 45420
Phone (937) 252-1831

3080 Ackerman Blvd
Ste 110
Kettering, OH 45429
Phone (937) 293-5080

Organizations & group practices 3

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 6

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": "1523059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1154828069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2261 PHILADELPHIA DR STE 300",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454061814",
            "telephone_number": "937-734-4141",
            "fax_number": "937-277-7249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2261 PHILADELPHIA DR STE 301",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "45406",
            "telephone_number": "937-734-4141",
            "fax_number": "937-277-7249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIDRICH",
        "first_name": "JENNIFER",
        "middle_name": "LIANG",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-07",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34.015883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "HEMSTREET",
            "middle_name": "LIANG",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.