Individual provider Active NPI

Jacqueline S Lather, DNP, CNP

  • Nurse Practitioner
  • Marietta, OH
National Provider Identifier
1275706186
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN.CNP.09981 Issued in OH
Practice address
800 Wayne St Ste 112
Marietta, OH 45750-3309
Phone
(740) 373-4288
Fax
(740) 373-4254
NPI assigned
Apr 11, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN.CNP.09981 OH Primary

Addresses

Primary practice location

800 Wayne St Ste 112
Marietta, OH 45750-3309

Mailing address

PO Box 449
Marietta, OH 45750-0449

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
I20090306000359 OH Practitioner - Nurse Practitioner 5597821025

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CNP.09981OHMDNurse Practitioner

Interoperability endpoints

  • Direct secure messaging: jacqueline.lather@mmhs.medicity.net

NPI Registry JSON

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

{
    "created_epoch": "1207872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1275706186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 449",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457500449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WAYNE ST STE 112",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457503309",
            "telephone_number": "740-373-4288",
            "fax_number": "740-373-4254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATHER",
        "first_name": "JACQUELINE",
        "middle_name": "S",
        "credential": "DNP, CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-11",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.09981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, OH

Sources for this page

Verify at the official NPI Registry.