Individual provider Active NPI

Jessica Paterni

  • Family Nurse Practitioner
  • Canonsburg, PA
National Provider Identifier
1750117974
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP030675 Issued in PA
Practice address
100 Medical Blvd
Canonsburg, PA 15317-9762
Phone
(724) 745-6100
NPI assigned
Sep 12, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP030675 PA Primary

Addresses

Primary practice location

100 Medical Blvd
Canonsburg, PA 15317-9762

Mailing address

100 Medical Blvd
Canonsburg, PA 15317-9762

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250408002980 WV Practitioner - Nurse Practitioner 0042734360 Reassigns benefits to 1 organization
I20250724003773 OH Practitioner - Nurse Practitioner 0042734360 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP030675PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors Urgent Care LLC CurrentSince Jul 16, 2025 Accepting new patients
Dr. Vic Wood Inc CurrentSince Mar 31, 2025 Accepting new patients
Valley Radiologists Inc PastSince Mar 31, 2025 Accepting new patients

Locations

51342 National Rd
Ste A
St Clairsvle, OH 43950
Phone (740) 699-0940

24 Homestead Ave
Wheeling, WV 26003
Phone (304) 232-1020

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1726099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1750117974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MEDICAL BLVD",
            "city": "CANONSBURG",
            "state": "PA",
            "postal_code": "153179762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEDICAL BLVD",
            "city": "CANONSBURG",
            "state": "PA",
            "postal_code": "153179762",
            "telephone_number": "724-745-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATERNI",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-12",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP030675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canonsburg, PA

Sources for this page

Verify at the official NPI Registry.