Individual provider Active NPI

Jennifer J Dolly, APRN-CNM

  • Advanced Practice Midwife
  • Cleveland, OH
National Provider Identifier
1316562663
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
APRN.CNM.019438 Issued in OH
Practice address
9500 Euclid Ave
Cleveland, OH 44195-3834
Phone
(330) 807-7439
NPI assigned
Jun 12, 2020
Last updated
Nov 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X APRN.CNM019438 OH
Advanced Practice Midwife 367A00000X APRN.CNM.019438 OH Primary

Addresses

Primary practice location

9500 Euclid Ave
Cleveland, OH 44195-3834

Mailing address

8457 Summer Rd
Macedonia, OH 44056-1717
Phone (330) 807-7439

Other practice location 1

2150 W Central Ave
Toledo, OH 43606-3834
Phone (419) 291-4000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jdolly205981@epicdirect.promedica.org

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200922003206 OH Practitioner - Certified Nurse Midwife (CNM) 7911325006 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CNM.019438OHMDAdvanced Practice Midwife
APRN.CNM019438OHMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
The Toledo Hospital CurrentSince Sep 1, 2020 Accepting new patients
The Cleveland Clinic Foundation CurrentSince Oct 11, 2023 Accepting new patients
The Toledo Hospital CurrentSince Sep 1, 2020 Accepting new patients
The Cleveland Clinic Foundation Past Accepting new patients

Locations

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111

2150 W Central Ave
Toledo, OH 43606
Phone (419) 291-2200

Interoperability endpoints

  • Direct secure messaging: jdolly205981@direct.promedica.org

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": "1591920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1316562663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8457 SUMMER RD",
            "city": "MACEDONIA",
            "state": "OH",
            "postal_code": "440561717",
            "telephone_number": "330-807-7439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441953834",
            "telephone_number": "330-807-7439"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2150 W Central Ave",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436063834",
            "country_code": "US",
            "telephone_number": "419-291-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOLLY",
        "first_name": "JENNIFER",
        "middle_name": "J",
        "credential": "APRN-CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-12",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "OH",
            "license": "APRN.CNM019438",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "OH",
            "license": "APRN.CNM.019438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jdolly205981@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.