Jennifer Lynn Midtlien, CNP

Primary specialty

Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X

License

11935-NP Issued in OH

Practice address

5300 Far Hills Ave
Dayton, OH 45429-2381

Phone

(937) 433-7536

Fax

(937) 433-9612

NPI assigned

Oct 13, 2010

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

Other identifiers 5

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, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatologists of Southwestern Ohio, LLCGroup PAC ID 7113973041, 116 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

99.15 of 100Reported as group

Promoting interoperability

99

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

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.

• Dermatologists of Southwestern Ohio, LLC.

  • Dermatology Physician
  • Dayton, OH
  • NPI 1801819883
  Medicare reassignment Care Compare group NPD
• Miami Valley Emergency Specialists, LLC

  • Emergency Medicine Physician
  • Dayton, OH
  • NPI 1821189085
  NPD (past)

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

{
    "created_epoch": "1286928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470182400000",
    "number": "1639489545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1016 PAXON DR",
            "city": "BELLBROOK",
            "state": "OH",
            "postal_code": "453058948",
            "telephone_number": "937-938-0136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 FAR HILLS AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454292381",
            "telephone_number": "937-433-7536",
            "fax_number": "937-433-9612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDTLIEN",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-13",
        "last_updated": "2016-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN260615",
            "primary": false
        },
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "OH",
            "license": "11935-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9328817",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0058747",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE OHIO",
            "identifier": "421534506186",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS OH",
            "identifier": "000000745200",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01005063",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Middleton
• Molly Christine Middleton, MD
• Natalie Jean Middleton
• Middletown Surgical Associates
• Midstates Radiology Consultants
• Midwest Behavioral Care, LTD
• Midwest Clinical Research Center
• Midwest Counseling Centers of Ohio
• Abigail Marie Migut, MA, CCC-SLP
• Erene Mihalas, DC

• Adult Health Clinical Nurse Specialist in Dayton, OH
• Providers in Dayton, OH by specialty
• Adult Health Clinical Nurse Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2016; 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.