Jennalee Danielle Simon, AGPCNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

APRN.CNP.0032589 Issued in OH

Practice address

6480 Rockside Woods Blvd S Ste 330
Independence, OH 44131-2222

Phone

(855) 490-9434

NPI assigned

Mar 30, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Illumia Health LLCGroup PAC ID 7810424306, 33 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Illumia Health LLC

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Akron, OH
  • NPI 1740024397

  OH

  Medicare reassignment Care Compare group NPD
• Illumia Health LLC

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • White Bear Lake, MN
  • NPI 1972316289
  NPD

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

{
    "created_epoch": "1680134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1508561697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 W WASHINGTON ST STE 1700",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606063404",
            "telephone_number": "855-490-9434",
            "fax_number": "216-238-9526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6480 ROCKSIDE WOODS BLVD S STE 330",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441312222",
            "telephone_number": "855-490-9434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "JENNALEE",
        "middle_name": "DANIELLE",
        "name_prefix": "Mrs.",
        "credential": "AGPCNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-30",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "APRN.CNP.0032589",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OH",
            "license": "APRN.CNP.0032589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shines Support LTD
• Billie J Shook, CNP
• Jeffrey B Shroyer, MD
• George R Sibel, PT
• Nicole Sieg
• Sincere Hearts Home Care LLC
• Sincere Hearts Home Care LLC
• Victoria Sirna
• Amy Sisley
• Mary Teresa Sivik, MD

• All providers in Independence, OH
• Gerontology Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.