Individual provider Active NPI

Stephanie Rose Jaeger

  • Licensed Practical Nurse
  • Sandusky, OH
National Provider Identifier
1235016312
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
184081 Issued in OH
Practice address
1036 Cleveland Rd
Sandusky, OH 44870-4034
Phone
(419) 504-0068
NPI assigned
Aug 19, 2025
Last updated
Dec 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 184081 OH Primary

Addresses

Primary practice location

1036 Cleveland Rd
Sandusky, OH 44870-4034

Mailing address

1036 Cleveland Rd
Sandusky, OH 44870-4034

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
184081OHMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Treatment Centers Oh-XII, LLC CurrentSince Dec 21, 2025 Accepting new patients
Midwest Detox Center LLC Past Accepting new patients
Midwest Detox Center LLC Past Accepting new patients
Valor Recovery Center of Youngstown LLC Past Accepting new patients
Midwest Recovery Center LLC Past Accepting new patients
Midwest Recovery Center LLC Past Accepting new patients
Valor Recovery Center of Youngstown LLC Past Accepting new patients

Locations

1036 Cleveland Rd
Sandusky, OH 44870
Phone (419) 504-0068

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1755561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765843200000",
    "number": "1235016312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1036 CLEVELAND RD",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448704034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1036 CLEVELAND RD",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448704034",
            "telephone_number": "419-504-0068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAEGER",
        "first_name": "STEPHANIE",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-19",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "184081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandusky, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.