Jennifer L Lakeberg, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

APRN.CNP.14477 Issued in OH

Practice address

1 Childrens PLZ
Dayton, OH 45404-1815

Phone

(937) 641-3600

Fax

(937) 641-5802

NPI assigned

Aug 12, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dayton Childrens Specialty Physicians IncGroup PAC ID 5496916124, 93 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Dayton Children'S Specialty Physicians, Inc.

  • Pediatrics Physician
  • Dayton, OH
  • NPI 1225192610

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Dayton Children'S Hospital

  • Child & Adolescent Psychiatry Physician
  • Dayton, OH
  • NPI 1952480030

  Pediatrics

  Medicare reassignment NPD
• Mercy Health Physicians Cincinnati Specialty Care LLC

  • Surgery Physician
  • Blue Ash, OH
  • NPI 1154942795

  Nurse Practitioner

  Medicare reassignment NPD
• Dayton Children'S Specialty Physicians, Inc.

  • Pediatrics Physician
  • Dayton, OH
  • NPI 1780467555
  NPD
• Mercy Health Physicians Cincinnati Specialty Care LLC

  • Durable Medical Equipment & Medical Supplies
  • Liberty TWP, OH
  • NPI 1730993270
  NPD
• Dayton Children'S Hospital

  • Urgent Care Clinic/Center
  • Miamisburg, OH
  • NPI 1730392309

  Nurse Practitioner

  NPD (past)

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

{
    "created_epoch": "1376265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779926400000",
    "number": "1295168409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 933432",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930039",
            "telephone_number": "937-641-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PLZ",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454041815",
            "telephone_number": "937-641-3600",
            "fax_number": "937-641-5802"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8501 Old Troy Pike",
            "address_purpose": "LOCATION",
            "city": "Huber Heights",
            "state": "OH",
            "postal_code": "454241054",
            "country_code": "US",
            "telephone_number": "937-641-4360",
            "fax_number": "937-641-3791",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "860 Valley St.",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "45404",
            "country_code": "US",
            "telephone_number": "937-641-3060",
            "fax_number": "937-641-3285",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4760 E Galbraith Rd Ste 212",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452366704",
            "country_code": "US",
            "telephone_number": "513-829-1700",
            "fax_number": "513-310-4019",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3333 W Tech Rd",
            "address_purpose": "LOCATION",
            "city": "Miamisburg",
            "state": "OH",
            "postal_code": "453420955",
            "country_code": "US",
            "telephone_number": "937-641-5725",
            "fax_number": "937-350-3050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "234 Goodman St",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452192364",
            "country_code": "US",
            "telephone_number": "513-558-5281",
            "fax_number": "513-558-5791",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6044 Wilmington Pike",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454597006",
            "country_code": "US",
            "telephone_number": "937-641-3270",
            "fax_number": "937-641-6108",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "792 Northwoods Blvd",
            "address_purpose": "LOCATION",
            "city": "Vandalia",
            "state": "OH",
            "postal_code": "453779462",
            "country_code": "US",
            "telephone_number": "937-641-4236",
            "fax_number": "937-641-4237",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7787 Cox Ln",
            "address_purpose": "LOCATION",
            "city": "West Chester",
            "state": "OH",
            "postal_code": "450696549",
            "country_code": "US",
            "telephone_number": "937-641-5757",
            "fax_number": "513-847-1192",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3301 Dayton Xenia Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Beavercreek",
            "state": "OH",
            "postal_code": "454322759",
            "country_code": "US",
            "telephone_number": "937-641-5098",
            "fax_number": "937-912-9395",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4475 Far Hills Ave",
            "address_purpose": "LOCATION",
            "city": "Kettering",
            "state": "OH",
            "postal_code": "454292405",
            "country_code": "US",
            "telephone_number": "937-641-3141",
            "fax_number": "937-641-3190",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "662 N Main St",
            "address_purpose": "LOCATION",
            "city": "Springboro",
            "state": "OH",
            "postal_code": "450669553",
            "country_code": "US",
            "telephone_number": "937-641-5066",
            "fax_number": "937-550-9797",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1711 Germantown Pike",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "45417",
            "country_code": "US",
            "telephone_number": "937-641-3142",
            "fax_number": "937-641-4172",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAKEBERG",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-12",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OH",
            "license": "APRN.CNP.14477",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "APRN.CNP.14477",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OH",
            "license": "APRN.CNP.14477",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0102190",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Olivia Lair, LSW
• Grace Katherine Lairson, STNA
• Justin Jefferey Lake
• Karly Jean Lake
• Stephanie Ann Lake, DO
• Carlee Anne Lakes
• Casey Lakes
• Dylan Lakes
• Randall Eugene Lakes, RN
• Tiera Lakes

• Pediatric Nurse Practitioner in Dayton, OH
• Providers in Dayton, OH by specialty
• Pediatric Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.