Jenifer M. Eubanks, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

COA. 13597-NP Issued in OH

Practice address

20265 Emery Rd
North Randall, OH 44128-4122

Phone

(440) 523-9966

Fax

(216) 584-2895

NPI assigned

Aug 7, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

State licenses

Practice roles

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.

• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

{
    "created_epoch": "1344297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424822400000",
    "number": "1669729885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1621 KNOB HILL DRIVE",
            "city": "COSHOCTON",
            "state": "OH",
            "postal_code": "438123136",
            "telephone_number": "740-294-7758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20265 EMERY RD",
            "city": "NORTH RANDALL",
            "state": "OH",
            "postal_code": "441284122",
            "telephone_number": "440-523-9966",
            "fax_number": "216-584-2895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EUBANKS",
        "first_name": "JENIFER",
        "middle_name": "M.",
        "name_prefix": "Mrs.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-07",
        "last_updated": "2015-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA. 13597-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Citie One Family Practice
• Cole Vision Corporation
• Shayna Davis, CFY-SLP
• Joseph I. Disser, RN, NP-C
• Emery Leasing Co., LLC
• Shiamyra Graham
• Tamar Hartman, M.A.
• Samuel Holmes
• Vincent Keith Hunt
• Stacy M. Hutchinson

• Family Nurse Practitioner in North Randall, OH
• Providers in North Randall, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.