Individual provider Active NPI

Jeanne-Marie Ngantcha Nkenglefac

  • Psychiatric/Mental Health Nurse Practitioner
  • Brunswick, OH
National Provider Identifier
1316811698
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN.CNP.0039995 Issued in OH
Practice address
5176 Salton Dr
Brunswick, OH 44212-6420
Phone
(918) 971-8712
NPI assigned
Oct 1, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN.CNP.0039995 OH Primary

Addresses

Primary practice location

5176 Salton Dr
Brunswick, OH 44212-6420

Mailing address

5176 Salton Dr
Brunswick, OH 44212-6420

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
I20251110001499 OH Practitioner - Nurse Practitioner 4385134162 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2570 Lynn Rd
Chappell Hill, TX 77426-2800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0039995OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cityblock Medical Practice, LLC CurrentSince Oct 1, 2025 Accepting new patients

Locations

495 Flatbush Ave
Ste C5
Brooklyn, NY 11225
Phone (215) 588-1676

800 N High St
Ste 4102
Columbus, OH 43215
Phone (347) 463-5529

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1759276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1316811698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5176 SALTON DR",
            "city": "BRUNSWICK",
            "state": "OH",
            "postal_code": "442126420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5176 SALTON DR",
            "city": "BRUNSWICK",
            "state": "OH",
            "postal_code": "442126420",
            "telephone_number": "918-971-8712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NKENGLEFAC",
        "first_name": "JEANNE-MARIE",
        "middle_name": "NGANTCHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-01",
        "last_updated": "2025-10-01",
        "certification_date": "2025-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0039995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, OH

Sources for this page

Verify at the official NPI Registry.