Individual provider Active NPI

Jerry Ray Tapp Jr., RN, CNP

  • Adult Health Nurse Practitioner
  • Chillicothe, OH
National Provider Identifier
1467671123
Registry record updated Dec 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
07968 Issued in OH
Practice address
4437 State Route 159
Suite 125
Chillicothe, OH 45601-7065
Phone
(740) 779-4570
Fax
(740) 779-4579
NPI assigned
Apr 24, 2007
Last updated
Dec 16, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 07968 OH Primary

Addresses

Primary practice location

4437 State Route 159
Suite 125
Chillicothe, OH 45601-7065

Mailing address

272 Hospital Rd
Chillicothe, OH 45601-9031
Phone (740) 779-4570

Other identifiers 1

IdentifierTypeStateIssuer
2774476MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address adena.cardio@adena.medicity.net

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
I20070731000241 OH Practitioner - Nurse Practitioner 2769583020 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
82.93 of 100Reported as group
Quality
64.42
Promoting interoperability
99
Improvement activities
40
Cost
73.2

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
07968OHMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Adena Medical Group LLC CurrentSince Apr 1, 2010 Accepting new patients

Locations

272 Hospital Rd
Chillicothe, OH 45601
Phone (740) 779-4275

272 Hospital Rd
Ste 3
Chillicothe, OH 45601
Phone (740) 779-8234

4437 State Route 159
Ste 125
Chillicothe, OH 45601
Phone (740) 779-4570

4439 State Route 159
Ste 130
Chillicothe, OH 45601
Phone (740) 779-4360

12340 State Route 104
Waverly, OH 45690
Phone (740) 941-5180

Organizations & group practices 1

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": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608076800000",
    "number": "1467671123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "272 HOSPITAL RD",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456019031",
            "telephone_number": "740-779-4570",
            "fax_number": "740-779-4579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4437 STATE ROUTE 159",
            "address_2": "SUITE 125",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456017065",
            "telephone_number": "740-779-4570",
            "fax_number": "740-779-4579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAPP",
        "first_name": "JERRY",
        "middle_name": "RAY",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "RN, CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "07968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2774476",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adena.cardio@adena.medicity.net",
            "affiliation": "N",
            "address_1": "4437 State Route 159",
            "address_2": "Suite 125",
            "city": "Chillicothe",
            "state": "OH",
            "country_code": "US",
            "postal_code": "456017065",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chillicothe, OH

Sources for this page

Verify at the official NPI Registry.