Jessica Jera Mandeville, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0033731 Issued in OH

Practice address

111 W Espy St
Kenton, OH 43326-2117

Phone

(419) 679-5994

NPI assigned

May 8, 2023

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

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Health and Wellness Partners of Logan CountyGroup PAC ID 8022247469, shared by 9 NPIs, 20 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hardin Memorial Hospital Hospital, Kenton, OH, CCN 361315

Medicare enrollment (NPD)

Enrolled

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.

• Health Partners of Western Ohio

  dba Old West End Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Toledo, OH
  • NPI 1760952741
  Medicare reassignment NPD
• Health Partners of Western Ohio

  dba Kenton Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Kenton, OH
  • NPI 1346588597
  NPD
• Health Partners of Western Ohio

  dba Springfield Health Center

  • Federally Qualified Health Center (FQHC)
  • Holland, OH
  • NPI 1396605481
  NPD
• Health Partners of Western Ohio

  dba Spartan Health Center

  • Federally Qualified Health Center (FQHC)
  • Lima, OH
  • NPI 1740694462
  NPD (past)
• Health Partners of Western Ohio

  dba Dr. Gene Wright Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Lima, OH
  • NPI 1811932288
  NPD (past)
• Lima Memorial Joint Operating Company

  dba Lima Memorial Health System

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Hardin Memorial Hospital

  • Critical Access Hospital
  • Kenton, OH
  • NPI 1437181518
  Care Compare affiliation

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

{
    "created_epoch": "1683504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1497445118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 N WEST ST",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458014331",
            "telephone_number": "419-221-3072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W ESPY ST",
            "city": "KENTON",
            "state": "OH",
            "postal_code": "433262117",
            "telephone_number": "419-679-5994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDEVILLE",
        "first_name": "JESSICA",
        "middle_name": "JERA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-08",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "0033731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lima Memorial Professional Corporation (LMPC Specialists at Kenton)
• Lima Memorial Professional Corporation (Kenton Medical Center)
• LMH Heart Institute of Northwest Ohio, LLC
• Cheyanne Lowery
• Shelby Luth, PHARMD
• Tamara Mansfield
• Brooklin Nicole Mauk, COTA/L
• Danielle Lea Mayer, PA-C
• Kaytie McGue
• Michael a Broseke D.C.

• Family Nurse Practitioner in Kenton, OH
• Providers in Kenton, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.