Active NPI
Kim Doreen Jantausch, LPN
- Licensed Practical Nurse
- Delaware, OH
National Provider Identifier
1609840354
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- PN 074584
- Practice address
- 96 Elizabeth St
Delaware, OH 43015-2446 - Phone
- (740) 363-8000
- Fax
- (740) 363-6419
- NPI assigned
- Feb 16, 2006
- Last updated
- Jul 13, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | PN 074584 | OH | Primary |
Addresses
Primary practice location
96 Elizabeth St
Delaware, OH 43015-2446
Mailing address
96 Elizabeth St
Delaware, OH 43015-2446
Phone (740) 363-8000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2173062 | Other | OH | INDEPENDENT PROVIDER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PN 074584 | OH | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1609840354",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "96 ELIZABETH ST",
"city": "DELAWARE",
"state": "OH",
"postal_code": "430152446",
"telephone_number": "740-363-8000",
"fax_number": "740-363-6419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "96 ELIZABETH ST",
"city": "DELAWARE",
"state": "OH",
"postal_code": "430152446",
"telephone_number": "740-363-8000",
"fax_number": "740-363-6419"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JANTAUSCH",
"first_name": "KIM",
"middle_name": "DOREEN",
"name_prefix": "Mrs.",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-16",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "OH",
"license": "PN 074584",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDEPENDENT PROVIDER",
"identifier": "2173062",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Delaware, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.