Jennifer Krusemark-Millin, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

34008389 Issued in OH

Practice address

4320 Cleveland Ave. SE
Canton, OH 44707

Phone

(330) 484-2584

Fax

(330) 484-3529

NPI assigned

Jul 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Jennifer Krusemark Former name

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

Specialty

Family Practice

Education

At Still University of Health Sciences, College of Osteo Med, Kirksville, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aultman North Canton Medical GroupGroup PAC ID 4082605266, 48 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Aultman Hospital Hospital, Canton, OH, CCN 360084
• Alliance Community Hospital Hospital, Alliance, OH, CCN 360131

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jennifer.krusemark-millin@direct.aultman.org

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.

• Aultman North Canton Medical Group

  • Multi-Specialty Clinic/Center
  • North Canton, OH
  • NPI 1245257088
  Medicare reassignment Care Compare group NPD
• North Canton Medical Foundation

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • North Canton, OH
  • NPI 1649383340
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Alliance Community Hospital

  • General Acute Care Hospital
  • Alliance, OH
  • NPI 1942385794
  Care Compare affiliation
• Aultman Hospital

  • General Acute Care Hospital
  • Canton, OH
  • NPI 1356366991
  Care Compare affiliation

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349136000000",
    "number": "1215952262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6046 WHIPPLE AVE NW",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447207616",
            "telephone_number": "330-484-2584",
            "fax_number": "330-484-3529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 CLEVELAND AVE. SE",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "44707",
            "telephone_number": "330-484-2584",
            "fax_number": "330-484-3529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUSEMARK-MILLIN",
        "first_name": "JENNIFER",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2012-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34008389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "34008389",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2687570",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "KRUSEMARK",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Collin D Kroen, MD
• Molley Krstich, CT
• Lisa Anne Krumm, CRNA
• Thomas M Krupar, PT
• James Krupko, DPT
• Nina Marie Kucyk, PSY.D, PCC-S, NCC
• Carol Kuczynski, RN
• Paige Kuder, SWT
• Miran W. Kuendig, PH.D.
• Richard C. Kuendig, PSY.D.

• Family Medicine Physician in Canton, OH
• Providers in Canton, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.