Individual provider Active NPI

Lila Rose Jensen, CNM

  • Midwife
  • Dayton, OH
National Provider Identifier
1477062826
Registry record updated Sep 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
APRN.CNM.019323 Issued in OH
Practice address
1 Wyoming St
Dayton, OH 45409-2722
Phone
(937) 208-2007
NPI assigned
Sep 28, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.412779 OH
Midwife 176B00000X APRN.CNM.019323 OH Primary

Addresses

Primary practice location

1 Wyoming St
Dayton, OH 45409-2722

Mailing address

1 Wyoming St FL 1
Dayton, OH 45409-2722

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180124001854 OH Practitioner - Certified Nurse Midwife (CNM) 2567721335 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN.412779OHMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Five Rivers Health Centers CurrentSince Dec 10, 2017 Accepting new patients
Five Rivers Health Centers CurrentSince Dec 10, 2017 Accepting new patients

Locations

921 S Edwin C Moses Blvd
Dayton, OH 45417
Phone (937) 461-1376

2261 Philadelphia Dr
Dayton, OH 45406
Phone (937) 281-6800

1923 W 3rd St
Dayton, OH 45417
Phone (937) 371-0913

721 Miami Chapel Rd
Dayton, OH 45417
Phone (937) 281-5970

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1506556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506556800000",
    "number": "1477062826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WYOMING ST FL 1",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454092722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WYOMING ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454092722",
            "telephone_number": "937-208-2007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "LILA",
        "middle_name": "ROSE",
        "credential": "CNM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-28",
        "last_updated": "2017-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.412779",
            "primary": false
        },
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "OH",
            "license": "APRN.CNM.019323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.