Individual provider Active NPI

Jaclynn G Missler, MSN, APRN, FNP-C

  • Family Nurse Practitioner
  • Norwalk, OH
National Provider Identifier
1407526338
Registry record updated Nov 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.0029750 Issued in OH
Practice address
280 Benedict Ave Ste a
Norwalk, OH 44857-2374
Phone
(419) 668-8110
Fax
(419) 660-6996
NPI assigned
Sep 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0029750 OH
Family Nurse Practitioner 363LF0000X APRN.CNP.0029750 OH Primary

Addresses

Primary practice location

280 Benedict Ave Ste a
Norwalk, OH 44857-2374

Mailing address

272 Benedict Ave
Norwalk, OH 44857-2374
Phone (419) 668-8101

Other practice location 1

368 Milan Ave Ste D
Norwalk, OH 44857-3106
Phone (419) 663-6464

Other identifiers 1

IdentifierTypeStateIssuer
0460936MedicaidOH

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
I20220215000089 OH Practitioner - Nurse Practitioner 5890188809 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Yale University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fisher-Titus Medical Care LLCGroup PAC ID 6507940566, 82 clinicians

Practice addresses (Care Compare)

368 Milan Ave
Suite D
Norwalk, OH 44857-3106
Phone (419) 663-6464

Hospital & facility affiliations

  • Fisher-Titus Hospital Hospital, Norwalk, OH, CCN 360065
  • Firelands Regional Medical Center Hospital, Sandusky, OH, CCN 360025

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0029750OHMDFamily Nurse Practitioner
APRN.CNP.0029750OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fisher-Titus Medical Center Current Accepting new patients
Fisher-Titus Medical Care LLC CurrentSince Jan 1, 2023 Accepting new patients

Locations

368 Milan Ave
Ste D
Norwalk, OH 44857
Phone (419) 663-6464

280 Benedict Ave
#A
Norwalk, OH 44857
Phone (419) 668-0311

272 Benedict Ave
Norwalk, OH 44857
Phone (419) 668-1341

Organizations & group practices 2

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 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": "1631491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667952000000",
    "number": "1407526338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "272 BENEDICT AVE",
            "city": "NORWALK",
            "state": "OH",
            "postal_code": "448572374",
            "telephone_number": "419-668-8101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 BENEDICT AVE STE A",
            "city": "NORWALK",
            "state": "OH",
            "postal_code": "448572374",
            "telephone_number": "419-668-8110",
            "fax_number": "419-660-6996"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "368 Milan Ave Ste D",
            "address_purpose": "LOCATION",
            "city": "Norwalk",
            "state": "OH",
            "postal_code": "448573106",
            "country_code": "US",
            "telephone_number": "419-663-6464",
            "fax_number": "419-663-9881",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MISSLER",
        "first_name": "JACLYNN",
        "middle_name": "G",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-13",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "0029750",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0029750",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0460936",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, OH

Sources for this page

Verify at the official NPI Registry.