Individual provider Active NPI

Jennifer Louise Jones, PA-C

  • Physician Assistant
  • Springfield, OH
National Provider Identifier
1760707376
Registry record updated Aug 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50005503 Issued in OH
Practice address
1416 W 1St St
Springfield, OH 45504-1923
Phone
(937) 521-8150
NPI assigned
Apr 7, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50005503 OH Primary

Addresses

Primary practice location

1416 W 1St St
Springfield, OH 45504-1923

Mailing address

1910 Sassafras St
Erie, PA 16502-2716

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190111001098 OH Practitioner - Physician Assistant 9739376443 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Cleanslate Medical Group of Ohio LLCGroup PAC ID 9537418025, 10 clinicians

Practice addresses (Care Compare)

247 S Burnett Rd
Suite 110
Springfield, OH 45505-2661
Phone (937) 521-8150

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50005503OHMDPhysician Assistant

Organizations & group practices 1

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": "1270598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565827200000",
    "number": "1760707376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 SASSAFRAS ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165022716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1416 W 1ST ST",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455041923",
            "telephone_number": "937-521-8150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "JENNIFER",
        "middle_name": "LOUISE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-07",
        "last_updated": "2019-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50005503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OH

Sources for this page

Verify at the official NPI Registry.