Jennifer Obannon, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

3017386 Issued in KY

Practice address

125 S Main Cross St
Louisa, KY 41230-1065

Phone

(606) 638-0938

NPI assigned

Feb 2, 2022

Sex

Female

Sole proprietor

Yes

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 KY

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

Nurse Practitioner

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.

• University of Louisville Physicians, Inc.

  • Internal Medicine Physician
  • Louisville, KY
  • NPI 1366722316
  Medicare reassignment NPD
• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442

  KY, Psychiatry

  Medicare reassignment NPD
• Rise and Walk Psychiatric Services LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Prospect, KY
  • NPI 1568105021
  NPD Authorized official
• University of Louisville Physicians, Inc.

  • Radiation Oncology Physician
  • Louisville, KY
  • NPI 1124375936
  NPD
• University of Louisville Physicians, Inc.

  • Diagnostic Radiology Physician
  • Louisville, KY
  • NPI 1316294127
  NPD

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

{
    "created_epoch": "1643760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1740933324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 S MAIN CROSS ST",
            "city": "LOUISA",
            "state": "KY",
            "postal_code": "412301065",
            "telephone_number": "606-638-0938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 S MAIN CROSS ST",
            "city": "LOUISA",
            "state": "KY",
            "postal_code": "412301065",
            "telephone_number": "606-638-0938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBANNON",
        "first_name": "JENNIFER",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-02",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3017386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Brooke Norman, PSS
• Angela Danielle Null, LPCC
• Levelle O'Bannon
• Michael Christian O'Dell
• Carla Lee O'Guin
• Odyssey Inc
• Odyssey Inc
• Odyssey Inc
• Odyssey Inc
• Ohio Valley Physicians Inc

• Psychiatric/Mental Health Nurse Practitioner in Louisa, KY
• Providers in Louisa, KY by specialty
• Psychiatric/Mental Health Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2023; 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.