Active NPI
Jennifer Ann Cruz, PA-C
- Medical Physician Assistant
- Lima, OH
National Provider Identifier
1710184940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 50.004138
- Practice address
- 1001 Bellefontaine Ave FL 7
Lima, OH 45804-2800 - Phone
- (419) 998-4496
- Fax
- (419) 998-4463
- NPI assigned
- Jun 29, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA 9105529 | FL | |
| Medical Physician Assistant | 363AM0700X | 50.004138 | OH | Primary |
Addresses
Primary practice location
1001 Bellefontaine Ave FL 7
Lima, OH 45804-2800
Mailing address
1001 Bellefontaine Ave
Lima, OH 45804-2800
Phone (419) 998-4575
Other names 1
- Jennifer Ann Bowman
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA 9105529 | FL | MD | Physician Assistant |
| 50.004138 | OH | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lima Memorial Professional Corporation | Past | Accepting new patients | |
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
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.
-
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
-
- Family Medicine Physician
- Lima, OH
- NPI 1114978244
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574294400000",
"number": "1710184940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1001 BELLEFONTAINE AVE",
"city": "LIMA",
"state": "OH",
"postal_code": "458042800",
"telephone_number": "419-998-4575",
"fax_number": "419-998-4586"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 BELLEFONTAINE AVE FL 7",
"city": "LIMA",
"state": "OH",
"postal_code": "458042800",
"telephone_number": "419-998-4496",
"fax_number": "419-998-4463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUZ",
"first_name": "JENNIFER",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-29",
"last_updated": "2019-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA 9105529",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "OH",
"license": "50.004138",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "BOWMAN",
"middle_name": "ANN",
"credential": "PA-C",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Lima, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.