Individual provider Active NPI

Jennifer Lynn Kotsanis, NP

  • Family Nurse Practitioner
  • Saint Clairsville, OH
National Provider Identifier
1427495639
Registry record updated Nov 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.14147 Issued in OH
Practice address
302 W Main St
Saint Clairsville, OH 43950-8801
Phone
(740) 968-7256
NPI assigned
May 29, 2013
Last updated
Nov 3, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 83060 WV
Family Nurse Practitioner 363LF0000X APRN.CNP.14147 OH Primary

Addresses

Primary practice location

302 W Main St
Saint Clairsville, OH 43950-8801

Mailing address

302 W Main St
Saint Clairsville, OH 43950-8801
Phone (740) 968-7006

Other identifiers 1

IdentifierTypeStateIssuer
0085521MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20130712000111 WV Practitioner - Nurse Practitioner 9234379355 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CNP.14147OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
GR&W, Inc CurrentSince Apr 11, 2022 Accepting new patients
GR&W, Inc CurrentSince Apr 11, 2022 Accepting new patients

Locations

1005 White Willow Way
Morgantown, WV 26505
Phone (304) 212-7238

1100 Main St
Ste 104
Wheeling, WV 26003
Phone (304) 218-9405

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, 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": "1369785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509667200000",
    "number": "1427495639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 W MAIN ST",
            "city": "SAINT CLAIRSVILLE",
            "state": "OH",
            "postal_code": "439508801",
            "telephone_number": "740-968-7006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 W MAIN ST",
            "city": "SAINT CLAIRSVILLE",
            "state": "OH",
            "postal_code": "439508801",
            "telephone_number": "740-968-7256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTSANIS",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-29",
        "last_updated": "2017-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WV",
            "license": "83060",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.14147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0085521",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clairsville, OH

Sources for this page

Verify at the official NPI Registry.