Jennifer Lynn Shull, ANP-BC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

COA 11967-NP Issued in OH

Practice address

1383 W Hunter St
Logan, OH 43138-1013

Phone

(740) 385-0202

Fax

(740) 380-2734

NPI assigned

Oct 25, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hocking Valley Medical Group, Inc.Group PAC ID 0345238622, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hocking Valley Community Hospital Hospital, Logan, OH, CCN 361330

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jshull543392@direct.osumc.edu

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.

• Hocking Valley Medical Group, Inc.

  • Family Medicine Physician
  • Logan, OH
  • NPI 1801994827
  Medicare reassignment Care Compare group NPD
• Hocking Valley Community Hospital

  • Critical Access Hospital
  • Logan, OH
  • NPI 1295840007
  Medicare reassignment NPD
• Hocking Valley Community Hospital

  • Rural Health Clinic/Center
  • Logan, OH
  • NPI 1962059741
  NPD
• Hocking Valley Medical Group Transportation

  • Non-emergency Medical Transport (VAN)
  • Logan, OH
  • NPI 1417555087
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Hocking Valley Community Hospital

  • Critical Access Hospital
  • Logan, OH
  • NPI 1295840007
  Care Compare affiliation

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

{
    "created_epoch": "1287964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1801196852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 228",
            "city": "LOGAN",
            "state": "OH",
            "postal_code": "431380228",
            "telephone_number": "740-385-0202",
            "fax_number": "740-380-2734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1383 W HUNTER ST",
            "city": "LOGAN",
            "state": "OH",
            "postal_code": "431381013",
            "telephone_number": "740-385-0202",
            "fax_number": "740-380-2734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULL",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "ANP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-25",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "COA 11967-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3152725",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jshull@hvch.org",
            "affiliation": "N",
            "endpointDescription": "Hocking Valley Community Hospital, Rural Health Clinic",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1383 W Hunter St",
            "city": "Logan",
            "state": "OH",
            "country_code": "US",
            "postal_code": "431381013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Jessica Sisco, LPC
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• Adult Health Nurse Practitioner in Logan, OH
• Providers in Logan, OH by specialty
• Adult Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.