Jason Marc Etter, PRS

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

495 Metro PL S Ste 160
Dublin, OH 43017-5394

Phone

(614) 580-6917

NPI assigned

Jun 25, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Concord Psychiatry, LLC

  • Psychiatry Physician
  • Dublin, OH
  • NPI 1134508260
  NPD
• Concord Psychiatry, LLC

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Dublin, OH
  • NPI 1053901249
  NPD (past)

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

{
    "created_epoch": "1624579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1639749427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 METRO PL S STE 160",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430175394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 METRO PL S STE 160",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430175394",
            "telephone_number": "614-580-6917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETTER",
        "first_name": "JASON",
        "middle_name": "MARC",
        "credential": "PRS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-25",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jason.etter@emeraldpsychiatry.com",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "495 Metro Pl S Ste 160",
            "city": "Dublin",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430175394",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rebecca Esham
• Leann Eshelman
• Jocelyn Eskenazi
• Jessica Estep
• Roger Estep, CNP
• Amy Kathryn Evans, MS, ATC
• Diamond Evans
• Domonique Evans
• Kayle Brooke Evans
• Kirsten Evans

• Peer Specialist in Dublin, OH
• Providers in Dublin, OH by specialty
• Peer Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.