Jennifer Black, MSN, APRN, FNP-BC
Individual provider Active NPI Family Nurse Practitioner · Pataskala, OH
NPI 1427809656 · NPPES record last updated Mar 30, 2024
Key facts
- NPI
- 1427809656
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- APRN.CNP.0033046 (OH)
- Practice address
- 8910 Broad St SW
Pataskala, OH 43062-7886 - Phone
- (740) 927-6705
- NPI assigned
- Mar 27, 2024
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Central Ohio Urology Group, LLC.
Practice addresses (Care Compare)
350 W Wilson Bridge Rd
Suite 100
Worthington, OH 43085-2585
Phone (614) 268-2323
Hospital & facility affiliations
- Riverside Methodist Hospital
- Mount Carmel East & West
- Mount Carmel Dublin
- Grady Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240702003745 | OH | Practitioner - Nurse Practitioner | 4486198371 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science - Nursing
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN.CNP.0033046 | OH | MD | Family Nurse Practitioner |
Practice roles (3 of 7)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Signify Health, LLC | Current |
Accepting new patients | |
| Central Ohio Urology Group, LLC | Current |
Accepting new patients | |
| Central Ohio Urology Group, LLC | Current |
Accepting new patients |
Locations
175 S 3rd St
Ste 200
Columbus, OH 43215
Phone (267) 817-8902
8200 Hazelton Etna Rd SW
Etna, OH 43062
Phone (614) 221-5189
701 Tech Center Dr
Ste 100
Gahanna, OH 43230
Phone (440) 724-4498
701 Tech Center Dr
Ste 120
Gahanna, OH 43230
701 Tech Center Dr
Gahanna, OH 43230
Phone (614) 944-4806
350 W Wilson Bridge Rd
Ste 100
Worthington, OH 43085
Phone (614) 268-2323
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
- jblack4469522@direct.trinity-health.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APRN.CNP.0033046 | OH | Yes |
Addresses
Primary practice location
8910 Broad St SW
Pataskala, OH 43062-7886
Mailing address
1215 Brookridge Dr
Columbus, OH 43235-4004
Phone (614) 582-3570
Other providers in Pataskala, OH
- Patricia Jane Bennett
- Angela L Berry
- Better at Home Healthcare, LLC
- Sahira Shaneen Biland
- Emily Birnbrich
- Courtney E Block
- Nakisha Renee Bowman
- Brighthands Homecare Services LLC
- Amy Browand
- Clatina Brown
All providers in Pataskala, OH · Family Nurse Practitioner in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 30, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.