Individual provider Active NPI

Jessica Rae Bussey

  • Family Nurse Practitioner
  • Coventry Township, OH
National Provider Identifier
1801399415
Registry record updated Jun 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
025701 Issued in OH
Practice address
500 Portage Lakes Dr
Coventry Township, OH 44319-2299
Phone
(234) 867-6626
Fax
(234) 867-7766
NPI assigned
Mar 10, 2018
Last updated
Jun 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 275312 OH
Family Nurse Practitioner 363LF0000X 025701 OH Primary

Addresses

Primary practice location

500 Portage Lakes Dr
Coventry Township, OH 44319-2299

Mailing address

407 W Maple St
North Canton, OH 44720-2719
Phone (336) 682-8051

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
I20200612001304 OH Practitioner - Nurse Practitioner 1658622253 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Summa Physicians LLCGroup PAC ID 2961303532, 692 clinicians

Practice addresses (Care Compare)

500 Portage Lakes Dr
Suite B
Coventry Township, OH 44319-2299
Phone (234) 571-9933

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
275312OHMDRegistered Nurse
025701OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Summa Physicians LLC CurrentSince May 20, 2020 Accepting new patients
Summa Physicians LLC Current Accepting new patients
Summa Physicians LLC CurrentSince May 20, 2020 Accepting new patients
Summa Physicians LLC Past Accepting new patients

Locations

1077 Gorge Blvd
Akron, OH 44310
Phone (234) 312-5691

525 E Market St
Akron, OH 44304
Phone (330) 375-6350

500 Portage Lakes Dr
Ste B
Coventry Township, OH 44319
Phone (330) 245-1608

Interoperability endpoints

  • Direct secure messaging: jbussey22192@summahealth-direct.org

Organizations & group practices 4

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 3

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": "1520640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749686400000",
    "number": "1801399415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 W MAPLE ST",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447202719",
            "telephone_number": "336-682-8051",
            "fax_number": "234-867-7766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 PORTAGE LAKES DR",
            "city": "COVENTRY TOWNSHIP",
            "state": "OH",
            "postal_code": "443192299",
            "telephone_number": "234-867-6626",
            "fax_number": "234-867-7766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSSEY",
        "first_name": "JESSICA",
        "middle_name": "RAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-10",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "275312",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "025701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coventry Township, OH

Sources for this page

Verify at the official NPI Registry.