Jessica Lynn Tattershall, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

34.012084 Issued in OH

Practice address

5480 Norquest Blvd
Austintown, OH 44515-1820

Phone

(330) 779-0529

Fax

(330) 797-0403

NPI assigned

Apr 9, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Children'S Hospital Medical Center of Akron

  • Pediatrics Physician
  • Akron, OH
  • NPI 1841328853
  Medicare reassignment NPD
• Akron Children'S Hospital

  • Children's Hospital
  • Akron, OH
  • NPI 1942465752
  NPD
• Children'S Hospital Medical Center of Akron

  • Anesthesiology Physician
  • Boardman, OH
  • NPI 1417257601
  NPD
• Children'S Hospital Medical Center of Akron

  • Home Infusion Agency
  • Akron, OH
  • NPI 1649485848
  NPD
• Children'S Hospital Medical Center of Akron

  • Diagnostic Radiology Physician
  • Akron, OH
  • NPI 1780857797
  NPD
• Mercy Health Youngstown LLC

  • General Acute Care Hospital
  • Youngstown, OH
  • NPI 1790868982
  NPD (past)

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

{
    "created_epoch": "1365465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615161600000",
    "number": "1487097465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PERKINS SQ",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443081063",
            "telephone_number": "330-779-0529",
            "fax_number": "330-797-0403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5480 NORQUEST BLVD",
            "city": "AUSTINTOWN",
            "state": "OH",
            "postal_code": "445151820",
            "telephone_number": "330-779-0529",
            "fax_number": "330-797-0403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATTERSHALL",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-09",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "34.012084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jtattershall24666@direct.chmca.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5480 Norquest Blvd",
            "city": "Austintown",
            "state": "OH",
            "country_code": "US",
            "postal_code": "445151820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Eric Szymanski, M.D.
• Seth Takacs, CDCA
• Chris Talbert
• Zach Talbert, CDCA
• Susan Tamulonis
• Jasmine L Taylor
• Stephen Teneyck
• William Wells Tharp
• Reyna Marian Thomae-Starzyk, LISW-S
• Thomas M Grischow OD Inc

• Pediatrics Physician in Austintown, OH
• Providers in Austintown, OH by specialty
• Pediatrics Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.