Jennifer J Dement

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

405917 Issued in OH

Practice address

117 W Main St Ste 107
Lancaster, OH 43130-3799

Phone

(740) 883-9300

NPI assigned

Jul 27, 2022

Last updated

Apr 5, 2023By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1658880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1649906025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 396",
            "city": "SPRINGBORO",
            "state": "OH",
            "postal_code": "450660396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 W MAIN ST STE 107",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431303799",
            "telephone_number": "740-883-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMENT",
        "first_name": "JENNIFER",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-27",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "405917",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Carissa Dersam

• Registered Nurse in Lancaster, OH
• Providers in Lancaster, OH by specialty
• Registered Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2023; 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.