Individual provider Active NPI

Jeanie Cherryholmes, NP

  • Nurse Practitioner
  • Portsmouth, OH
National Provider Identifier
1174560411
Registry record updated Aug 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
05467 Issued in OH
Practice address
1805 27TH St
Portsmouth, OH 45662-2640
Phone
(740) 356-5000
NPI assigned
Jun 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2019

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 05467 OH Primary

Addresses

Primary practice location

1805 27TH St
Portsmouth, OH 45662-2640

Mailing address

2000 Green Rd
Suite 300
Ann Arbor, MI 48105-1598
Phone (734) 995-3764

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
I20040205000754 OH Practitioner - Nurse Practitioner 0143113886 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
05467OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Epmg of Ohio Inc P a Nurse Practitioner CurrentSince Nov 29, 1999 Accepting new patients

Locations

2000 Green Rd
Ste 300
Ann Arbor, MI 48105
Phone (313) 995-3764

1805 27th St
Portsmouth, OH 45662
Phone (740) 356-5000

1248 Kinneys Ln
Portsmouth, OH 45662
Phone (740) 353-2131

8770 Ohio River Rd
Wheelersburg, OH 45694
Phone (740) 355-4120

Interoperability endpoints

  • Direct secure messaging: jeanie.cherryholmes@somc.medicity.net

Organizations & group practices 1

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565740800000",
    "number": "1174560411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 GREEN RD",
            "address_2": "SUITE 300",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481051598",
            "telephone_number": "734-995-3764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 27TH ST",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456622640",
            "telephone_number": "740-356-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHERRYHOLMES",
        "first_name": "JEANIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2019-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "05467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, OH

Sources for this page

Verify at the official NPI Registry.