Individual provider Active NPI

Jennifer S Hostetler, CNP

  • Women's Health Nurse Practitioner
  • Canton, OH
National Provider Identifier
1679761860
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
NP-09672 Issued in OH
Practice address
2600 7TH St SW
Canton, OH 44710-1709
Phone
(330) 363-4920
NPI assigned
Oct 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X NP-09672 OH Primary

Addresses

Primary practice location

2600 7TH St SW
Canton, OH 44710-1709

Mailing address

2600 Tuscarawas St W
Canton, OH 44708-4644
Phone (330) 363-6296

Other identifiers 3

IdentifierTypeStateIssuer
2790001MedicaidOH
RX-09672OtherOHOHIO BOARD OF NURSING
RN-302146OtherOHOHIO BOARD OF NURSING

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP-09672OHMDWomen's Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1192147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1679761860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 TUSCARAWAS ST W",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447084644",
            "telephone_number": "330-363-6296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 7TH ST SW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447101709",
            "telephone_number": "330-363-4920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOSTETLER",
        "first_name": "JENNIFER",
        "middle_name": "S",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-12",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "OH",
            "license": "NP-09672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2790001",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO BOARD OF NURSING",
            "identifier": "RX-09672",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO BOARD OF NURSING",
            "identifier": "RN-302146",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; 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.