Individual provider Active NPI

Jennifer Kristen Garrett, PA

  • Physician Assistant
  • Cincinnati, OH
National Provider Identifier
1275669210
Registry record updated Apr 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50001699 Issued in OH
Practice address
222 Piedmont Ave
Cincinnati, OH 45219-2489
Phone
(513) 475-8787
Fax
(513) 475-7348
NPI assigned
Feb 26, 2007
Last updated
Apr 3, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50001699 OH Primary

Addresses

Primary practice location

222 Piedmont Ave
Cincinnati, OH 45219-2489

Mailing address

3200 Burnet Ave
3 South, Credentialing
Cincinnati, OH 45229-3019
Phone (513) 475-8787

Other identifiers 1

IdentifierTypeStateIssuer
0067482MedicaidOH

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070718000221 OH Practitioner - Physician Assistant 3779684972 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50001699OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Cincinnati Medical Center, LLC Physician Assistant Current Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
University Surgical-Dental Associates, LLC Past Accepting new patients

Locations

3199 Highland Ave
Cincinnati, OH 45219
Phone (513) 475-7777

3199 Highland Ave
Ofc
Cincinnati, OH 45219

3200 Burnet Ave
#3S
Cincinnati, OH 45229

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, 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": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428019200000",
    "number": "1275669210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 BURNET AVE",
            "address_2": "3 SOUTH, CREDENTIALING",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293019",
            "telephone_number": "513-475-8787",
            "fax_number": "513-475-7348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 PIEDMONT AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452192489",
            "telephone_number": "513-475-8787",
            "fax_number": "513-475-7348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRETT",
        "first_name": "JENNIFER",
        "middle_name": "KRISTEN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2015-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50001699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0067482",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.