NPIMap

Individual provider Active NPI

Jenna Ballou, FNP

  • Family Nurse Practitioner
  • Beavercreek, OH
National Provider Identifier
1306450176
Registry record updated Feb 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.0027460 Issued in OH
Practice address
2633 Commons Blvd Ste 120
Beavercreek, OH 45431-3827
Phone
(937) 429-0607
Fax
(937) 702-9041
NPI assigned
Aug 31, 2020
Last updated
Feb 20, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.0027460 OH Primary

Addresses

Primary practice location

2633 Commons Blvd Ste 120
Beavercreek, OH 45431-3827

Mailing address

2633 Commons Blvd Ste 120
Beavercreek, OH 45431-3827
Phone (937) 986-1862

Other names 1

  • Jenna McConnell Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211227001293 OH Practitioner - Nurse Practitioner 2062803117 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Internal Medicine Care, IncGroup PAC ID 8527959113, 8 clinicians

Practice addresses (Care Compare)

2633 Commons Blvd
Suite 120
Beavercreek, OH 45431-3827
Phone (937) 429-0607

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0027460OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine Care, Inc Current Accepting new patients
Internal Medicine Care, Inc CurrentSince Jan 3, 2022 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

2510 Commons Blvd
Ste 210
Beavercreek, OH 45431
Phone (937) 558-3062

2633 Commons Blvd
Ste 120
Beavercreek, OH 45431
Phone (937) 427-7540

1989 Miamisburg Centerville Rd
Ste 304
Dayton, OH 45459
Phone (937) 223-6837

Interoperability endpoints

  • Direct secure messaging: jenna.mcconnell.1@442.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 6

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": "1598832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771545600000",
    "number": "1306450176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2633 COMMONS BLVD STE 120",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454313827",
            "telephone_number": "937-986-1862",
            "fax_number": "937-702-9041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2633 COMMONS BLVD STE 120",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454313827",
            "telephone_number": "937-429-0607",
            "fax_number": "937-702-9041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLOU",
        "first_name": "JENNA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-31",
        "last_updated": "2026-02-20",
        "certification_date": "2026-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0027460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNA",
            "last_name": "MCCONNELL",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Beavercreek, OH

Sources for this page

Verify at the official NPI Registry.