Active NPI
Kathy M Jett, CRNP
- Adult Health Nurse Practitioner
- Dover, OH
National Provider Identifier
1790728970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 04286
- Practice address
- 300 Medical Park Dr
Suite 205
Dover, OH 44622-2073 - Phone
- (330) 364-4600
- Fax
- (330) 364-3338
- NPI assigned
- Jun 14, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 04286 | OH | Primary |
Addresses
Primary practice location
300 Medical Park Dr
Suite 205
Dover, OH 44622-2073
Mailing address
300 Medical Park Dr
Suite 205
Dover, OH 44622-2073
Phone (330) 364-4600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2358470 | Medicaid | OH |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 04286 | OH | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summa Physicians LLC | Past | Accepting new patients |
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.
-
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- Uniontown, OH
- NPI 1457662769
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1790728970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 MEDICAL PARK DR",
"address_2": "SUITE 205",
"city": "DOVER",
"state": "OH",
"postal_code": "446222073",
"telephone_number": "330-364-4600",
"fax_number": "330-364-3338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 MEDICAL PARK DR",
"address_2": "SUITE 205",
"city": "DOVER",
"state": "OH",
"postal_code": "446222073",
"telephone_number": "330-364-4600",
"fax_number": "330-364-3338"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JETT",
"first_name": "KATHY",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-14",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "OH",
"license": "04286",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2358470",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dover, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.