Individual provider Active NPI

Jenna Green, CNP

  • Adult Health Nurse Practitioner
  • Akron, OH
National Provider Identifier
1437524519
Registry record updated Dec 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
COA.17795-NP Issued in OH
Practice address
1 Akron General Ave
Akron, OH 44307-2432
Phone
(330) 344-6611
NPI assigned
Dec 1, 2015
Last updated
Dec 1, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X COA.17795-NP OH Primary
Gerontology Nurse Practitioner 363LG0600X COA.17795-NP OH

Addresses

Primary practice location

1 Akron General Ave
Akron, OH 44307-2432

Mailing address

1 Akron General Ave
Akron, OH 44307-2432

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
I20151221002139 OH Practitioner - Nurse Practitioner 6305147109 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Care Inc.Group PAC ID 1052207727, 65 clinicians

Practice addresses (Care Compare)

944 Cherry St E
Canal Fulton, OH 44614-8669
Phone (330) 854-4574

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
COA.17795-NPOHMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Care Inc. CurrentSince Oct 30, 2017 Accepting new patients
Radiology Associates of Canton, Inc. PastSince Oct 30, 2017 Accepting new patients

Locations

944 Cherry St E
Canal Fulton, OH 44614
Phone (330) 854-4281

Interoperability endpoints

  • Direct secure messaging: jenna.green@chci.eclinicaldirectplus.com

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.

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": "1448928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448928000000",
    "number": "1437524519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 AKRON GENERAL AVE",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443072432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 AKRON GENERAL AVE",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443072432",
            "telephone_number": "330-344-6611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "JENNA",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-01",
        "last_updated": "2015-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "COA.17795-NP",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OH",
            "license": "COA.17795-NP",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

Verify at the official NPI Registry.