Individual provider Active NPI

Jessica L Wobb, M.D.

  • Radiation Oncology Physician
  • Hamilton, OH
National Provider Identifier
1356653984
Registry record updated Nov 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
35126021 Issued in OH
Practice address
630 Eaton Ave
Hamilton, OH 45013-2767
Phone
(513) 867-2315
Fax
(513) 867-2296
NPI assigned
Jul 12, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 4301096536 MI
Radiation Oncology Physician 2085R0001X 35126021 OH Primary

Addresses

Primary practice location

630 Eaton Ave
Hamilton, OH 45013-2767

Mailing address

630 Eaton Ave
Hamilton, OH 45013-2767
Phone (513) 867-2315

Other identifiers 1

IdentifierTypeStateIssuer
0129149MedicaidOH

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jwobb604029@direct.ketteringhealth.org
FHIR URL https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150708002711 OH Practitioner - Radiation Oncology 9133351356 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Temple University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohio Specialty Physicians CorporationGroup PAC ID 3476643479, 67 clinicians

Practice addresses (Care Compare)

2600 6TH St SW
Canton, OH 44710-1702
Phone (330) 363-6201

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.12 of 100Reported as group
Quality
77.5
Promoting interoperability
98
Improvement activities
40
Cost
74.58

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301096536MIMDRadiation Oncology Physician
35126021OHMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio Specialty Physicians Corporation CurrentSince Mar 14, 2022 Accepting new patients
Ohio Specialty Physicians Corporation CurrentSince Mar 14, 2022 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

2600 6th St SW
Canton, OH 44710
Phone (330) 363-2180

2600 Tuscarawas St W
Ste 520
Canton, OH 44708
Phone (330) 454-0702

Interoperability endpoints

  • Direct secure messaging: jessica.wobb@direct.aultman.org

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1278892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605225600000",
    "number": "1356653984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 EATON AVE",
            "city": "HAMILTON",
            "state": "OH",
            "postal_code": "450132767",
            "telephone_number": "513-867-2315",
            "fax_number": "513-867-2296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 EATON AVE",
            "city": "HAMILTON",
            "state": "OH",
            "postal_code": "450132767",
            "telephone_number": "513-867-2315",
            "fax_number": "513-867-2296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOBB",
        "first_name": "JESSICA",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-12",
        "last_updated": "2020-11-13",
        "certification_date": "2020-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MI",
            "license": "4301096536",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "OH",
            "license": "35126021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0129149",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwobb604029@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "630 Eaton Ave",
            "city": "Hamilton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "450132767",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "630 Eaton Ave",
            "city": "Hamilton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "450132767",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hamilton, OH

Sources for this page

Verify at the official NPI Registry.