Individual provider Active NPI

Jennifer Glaettli, CNP

  • Family Nurse Practitioner
  • Ashtabula, OH
National Provider Identifier
1801284344
Registry record updated Jan 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
COA16804-NP Issued in OH
Practice address
2422 Lake Ave
Ashtabula, OH 44004-4985
Phone
(440) 992-4422
NPI assigned
Jan 7, 2015
Last updated
Jan 7, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2015

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 COA16804-NP OH Primary

Addresses

Primary practice location

2422 Lake Ave
Ashtabula, OH 44004-4985

Mailing address

2422 Lake Ave
Ashtabula, OH 44004-4985
Phone (440) 992-4422

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
I20150302001132 OH Practitioner - Nurse Practitioner 8426374802 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Cincinnati College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ashtabula County Medical CenterGroup PAC ID 2668465600, 70 clinicians

Practice addresses (Care Compare)

2259 Lake Ave
Ashtabula, OH 44004-3437
Phone (440) 994-7654

2420 Lake Ave
Ashtabula, OH 44004-4954
Phone (440) 997-6969

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
COA16804-NPOHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ashtabula County Medical Center CurrentSince Jan 7, 2015 Accepting new patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients
Ashtabula County Medical Center CurrentSince Jan 7, 2015 Accepting new patients

Locations

2259 Lake Ave
Ashtabula, OH 44004
Phone (440) 994-7550

2420 Lake Ave
Ashtabula, OH 44004
Phone (216) 986-2919

2422 Lake Ave
Ashtabula, OH 44004
Phone (440) 992-4422

354 W Main Rd
Conneaut, OH 44030
Phone (440) 599-2262

234 N Chestnut St
Jefferson, OH 44047
Phone (440) 576-8933

Interoperability endpoints

  • Direct secure messaging: jglaettli282673@direct.ccf.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1420588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420588800000",
    "number": "1801284344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2422 LAKE AVE",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440044985",
            "telephone_number": "440-992-4422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2422 LAKE AVE",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440044985",
            "telephone_number": "440-992-4422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLAETTLI",
        "first_name": "JENNIFER",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-07",
        "last_updated": "2015-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA16804-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashtabula, OH

Sources for this page

Verify at the official NPI Registry.