Individual provider Active NPI

Jenna Fitzpatrick

  • Family Nurse Practitioner
  • Maumee, OH
National Provider Identifier
1386192987
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.19254 Issued in OH
Practice address
1661 Holland Rd
Maumee, OH 43537-4207
Phone
(419) 843-7800
NPI assigned
Sep 13, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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.19254 OH Primary

Addresses

Primary practice location

1661 Holland Rd
Maumee, OH 43537-4207

Mailing address

1661 Holland Rd.
Maumee, OH 43537
Phone (419) 843-7800

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
I20161108001879 OH Practitioner - Nurse Practitioner 0648559013 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Toledo College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Toledo Clinic IncorporatedGroup PAC ID 5698673382, 204 clinicians

Practice addresses (Care Compare)

1661 Holland Rd
Maumee, OH 43537-4207
Phone (419) 843-7800

4235 Secor Rd
Toldeo, OH 43623-4231
Phone (419) 874-3246

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN.CNP.19254OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Toledo Clinic Incorporated CurrentSince Sep 20, 2016 Accepting new patients
Toledo Clinic Incorporated CurrentSince Sep 20, 2016 Accepting new patients
Toledo Clinic Incorporated Past Accepting new patients

Locations

1661 Holland Rd
Maumee, OH 43537
Phone (419) 720-2005

4235 Secor Rd
Toledo, OH 43623
Phone (419) 214-4214

Interoperability endpoints

  • Direct secure messaging: jenna.fitzpatrick@toledoclinic.eclinicaldirectplus.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 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": "1473724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1386192987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1661 HOLLAND RD.",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "43537",
            "telephone_number": "419-843-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1661 HOLLAND RD",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435374207",
            "telephone_number": "419-843-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZPATRICK",
        "first_name": "JENNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-13",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.19254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maumee, OH

Sources for this page

Verify at the official NPI Registry.