Individual provider Active NPI

Jalana N Lazar, CNM

  • Advanced Practice Midwife
  • Dayton, OH
National Provider Identifier
1265685002
Registry record updated Sep 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
NM10353 Issued in OH
Practice address
9000 N Main St
Suite 234
Dayton, OH 45415-1180
Phone
(937) 277-8988
Fax
(937) 832-2421
NPI assigned
Oct 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X NM10353 OH Primary
Women's Health Nurse Practitioner 363LW0102X NP10479 OH

Addresses

Primary practice location

9000 N Main St
Suite 234
Dayton, OH 45415-1180

Mailing address

9000 N Main St
Suite 234
Dayton, OH 45415-1180
Phone (937) 277-8988

Other identifiers 1

IdentifierTypeStateIssuer
2905860MedicaidOH

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090423000683 OH Practitioner - Certified Nurse Midwife (CNM) 5890843270 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
NP10479OHMDWomen's Health Nurse Practitioner
NM10353OHMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Health Specialists Inc CurrentSince Oct 1, 2015 Accepting new patients
Premier Health Specialists Inc CurrentSince Oct 1, 2015 Accepting new patients
Premier Health Specialists Inc Current Accepting new patients
Premier Heart Associates, Inc Past Accepting new patients

Locations

6611 Clyo Rd
Ste D
Dayton, OH 45459
Phone (937) 208-7350

30 E Apple St
#6258
Dayton, OH 45409
Phone (937) 208-5300

9000 N Main St
Ste 234
Englewood, OH 45415

9000 N Main St
Ste 232
Englewood, OH 45415

7450 S Mason Montgomery Rd
Unit 201
Mason, OH 45040
Phone (513) 229-7791

450 N Hyatt St
Ste 304
Tipp City, OH 45371
Phone (937) 832-4773

Organizations & group practices 4

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": "1224806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315353600000",
    "number": "1265685002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 N MAIN ST",
            "address_2": "SUITE 234",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454151180",
            "telephone_number": "937-277-8988",
            "fax_number": "937-832-2421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 N MAIN ST",
            "address_2": "SUITE 234",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454151180",
            "telephone_number": "937-277-8988",
            "fax_number": "937-832-2421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZAR",
        "first_name": "JALANA",
        "middle_name": "N",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-24",
        "last_updated": "2011-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "OH",
            "license": "NM10353",
            "primary": true
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "OH",
            "license": "NP10479",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2905860",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.