Individual provider Active NPI

Jennifer Lynn Wurst, MD

  • Family Medicine Physician
  • Fairlawn, OH
National Provider Identifier
1275510166
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35082161W Issued in OH
Practice address
3009 Smith Rd Ste 350
Fairlawn, OH 44333-2670
Phone
(330) 665-4488
Fax
(330) 665-4489
NPI assigned
Dec 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35-08-2161 OH
Family Medicine Physician 207Q00000X 35082161W OH Primary

Addresses

Primary practice location

3009 Smith Rd Ste 350
Fairlawn, OH 44333-2670

Mailing address

3009 Smith Rd Ste 350
Fairlawn, OH 44333-2670
Phone (330) 665-4488

Other practice location 1

303 E Royalton Rd Ste 101
Broadview Hts, OH 44147-2591
Phone (440) 743-4740

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jenniferwurst@uhps.allscriptsdirect.net
Direct Messaging Address jenniferwurst@uhps.allscriptsdirect.net

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041123000946 OH Practitioner - Family Practice 5092770552 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3009 Smith Rd
Suite 350
Fairlawn, OH 44333-2670
Phone (330) 665-4488

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.15 of 100Reported as apm
Quality
82.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35082161WOHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Primary Care LLC Family Medicine CurrentSince Jan 31, 2025 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

3009 Smith Rd
Ste 350
Fairlawn, OH 44333
Phone (330) 665-0010

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CBBFAA/Endpoint/CBBFAA
  • Direct secure messaging: jwurst37520@ehrdirect.uhhospitals.org

Organizations & group practices 2

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1275510166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3009 SMITH RD STE 350",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443332670",
            "telephone_number": "330-665-4488",
            "fax_number": "330-665-4489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3009 SMITH RD STE 350",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443332670",
            "telephone_number": "330-665-4488",
            "fax_number": "330-665-4489"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "303 E Royalton Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Broadview Hts",
            "state": "OH",
            "postal_code": "441472591",
            "country_code": "US",
            "telephone_number": "440-743-4740",
            "fax_number": "440-743-4741",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WURST",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-30",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35-08-2161",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35082161W",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jenniferwurst@uhps.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "12744 State Rd",
            "city": "North Royalton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441333910",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jenniferwurst@uhps.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "303 E Royalton Rd Ste 101",
            "city": "Broadview Hts",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441472591",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fairlawn, OH

Sources for this page

Verify at the official NPI Registry.