Individual provider Active NPI

Jaclyn Lachmiller

  • Family Nurse Practitioner
  • Sylvania, OH
National Provider Identifier
1639553373
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
COA.17632-NP Issued in OH
Practice address
5300 Harroun Rd Ste 304
Sylvania, OH 43560-2146
Phone
(419) 824-1100
Fax
(419) 824-1771
NPI assigned
Jul 13, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X COA.17632-NP OH Primary

Addresses

Primary practice location

5300 Harroun Rd Ste 304
Sylvania, OH 43560-2146

Mailing address

5300 Harroun Rd Ste 304
Sylvania, OH 43560-2146
Phone (419) 824-1100

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jlachmiller26699@epicdirect.promedica.org

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150821013595 OH Practitioner - Nurse Practitioner 3779898572 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
COA.17632-NPOHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians CurrentSince Aug 1, 2015 Accepting new patients
Promedica Central Physicians CurrentSince Aug 1, 2015 Accepting new patients

Locations

5300 Harroun Rd
Ste 304
Sylvania, OH 43560
Phone (419) 824-1100

100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

Interoperability endpoints

  • Direct secure messaging: jlachmiller26699@direct.promedica.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1436745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1639553373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 HARROUN RD STE 304",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602146",
            "telephone_number": "419-824-1100",
            "fax_number": "419-824-1771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 HARROUN RD STE 304",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602146",
            "telephone_number": "419-824-1100",
            "fax_number": "419-824-1771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACHMILLER",
        "first_name": "JACLYN",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-13",
        "last_updated": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA.17632-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jlachmiller26699@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sylvania, OH

Sources for this page

Verify at the official NPI Registry.