Individual provider Active NPI

Jared Michael Lemon

  • Psychiatric/Mental Health Nurse Practitioner
  • Lexington, KY
National Provider Identifier
1619402450
Registry record updated Mar 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
3011456 Issued in KY
Practice address
161 Prosperous PL
Lexington, KY 40509-1898
Phone
(859) 368-0609
NPI assigned
May 1, 2017
Last updated
Mar 24, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 3011456 KY Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0028202 OH

Addresses

Primary practice location

161 Prosperous PL
Lexington, KY 40509-1898

Mailing address

161 Prosperous PL
Lexington, KY 40509-1898
Phone (859) 368-0609

Other practice location 1

23715 Mercantile Rd Ste A203
Beachwood, OH 44122-5918
Phone (216) 292-2880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180131000570 KY Practitioner - Nurse Practitioner 3971863523
I20220502002404 OH Practitioner - Nurse Practitioner 3971863523 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0028202OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Psycho Social Therapies,LTD CurrentSince Mar 24, 2022 Accepting new patients
Psycho Social Therapies,LTD CurrentSince Mar 24, 2022 Accepting new patients

Locations

23366 Commerce Park
Ste 100B
Beachwood, OH 44122
Phone (216) 292-2880

23715 Mercantile Rd
Ste A203
Beachwood, OH 44122
Phone (216) 292-2880

Interoperability endpoints

  • Direct secure messaging: pbc.jaredlemon@140097.advancedmd-direct.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1493596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648080000000",
    "number": "1619402450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 PROSPEROUS PL",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405091898",
            "telephone_number": "859-368-0609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 PROSPEROUS PL",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405091898",
            "telephone_number": "859-368-0609"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23715 Mercantile Rd Ste A203",
            "address_purpose": "LOCATION",
            "city": "Beachwood",
            "state": "OH",
            "postal_code": "441225918",
            "country_code": "US",
            "telephone_number": "216-292-2880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEMON",
        "first_name": "JARED",
        "middle_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-01",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3011456",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "0028202",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.