Individual provider Active NPI

Jenessa Blotter Lemon, DO

  • Student in an Organized Health Care Education/Training Program
  • Columbus, OH
National Provider Identifier
1164281259
Registry record updated Jul 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
395 W 12TH Ave FL 4
Columbus, OH 43210-1267
Phone
(614) 366-0768
NPI assigned
Mar 19, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

395 W 12TH Ave FL 4
Columbus, OH 43210-1267

Mailing address

3595 Olentangy River Rd
Columbus, OH 43214-3440
Phone (614) 566-5456

Other names 1

  • Ms. Jenessa Jill Blotter 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
I20240903000276 OH Order and Referring Only - Diagnostic RadiologyPractitioner - Diagnostic Radiology 0042759235

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1710806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751500800000",
    "number": "1164281259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3595 OLENTANGY RIVER RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432143440",
            "telephone_number": "614-566-5456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 W 12TH AVE FL 4",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101267",
            "telephone_number": "614-366-0768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEMON",
        "first_name": "JENESSA",
        "middle_name": "BLOTTER",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-19",
        "last_updated": "2025-07-03",
        "certification_date": "2025-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENESSA",
            "last_name": "BLOTTER",
            "middle_name": "JILL",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.