Active NPI
Jeanine S Huttner, M.D.
- Family Medicine Physician
- Sylvania, OH
National Provider Identifier
1184620015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 35048574
- Practice address
- 5300 Harroun Rd
304
Sylvania, OH 43560-2182 - Phone
- (419) 824-1100
- Fax
- (419) 824-1778
- NPI assigned
- Jun 24, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 35048574 | OH | Primary |
Addresses
Primary practice location
5300 Harroun Rd
304
Sylvania, OH 43560-2182
Mailing address
5300 Harroun Rd
304
Sylvania, OH 43560-2182
Phone (419) 824-1100
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 344428794 | Other | CA | BEECH STREET |
| 000000142498 | Other | OH | ANTHEM |
| 6891 | Other | MI | HEALTH PLAN OF MI |
| 0855025 | Medicaid | OH | |
| 4207270 | Other | OH | AETNA |
| 141887 | Other | MI | CARE CHOICE |
| 812 | Other | OH | PARAMOUNT |
| 344428794003 | Other | OH | HUMANA/TRICARE |
| 4115025 | Medicaid | MI | |
| OC03174 | Other | OH | NATIONWIDE |
| 344428794031 | Other | OH | CARE SOURCES |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395100800000",
"number": "1184620015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5300 HARROUN RD",
"address_2": "304",
"city": "SYLVANIA",
"state": "OH",
"postal_code": "435602182",
"telephone_number": "419-824-1100",
"fax_number": "419-824-1778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5300 HARROUN RD",
"address_2": "304",
"city": "SYLVANIA",
"state": "OH",
"postal_code": "435602182",
"telephone_number": "419-824-1100",
"fax_number": "419-824-1778"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUTTNER",
"first_name": "JEANINE",
"middle_name": "S",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-06-24",
"last_updated": "2014-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OH",
"license": "35048574",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BEECH STREET",
"identifier": "344428794",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000142498",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PLAN OF MI",
"identifier": "6891",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0855025",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4207270",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARE CHOICE",
"identifier": "141887",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PARAMOUNT",
"identifier": "812",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA/TRICARE",
"identifier": "344428794003",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4115025",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATIONWIDE",
"identifier": "OC03174",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARE SOURCES",
"identifier": "344428794031",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sylvania, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.