Active NPI
Jenna Grace Dombi
- Physician Assistant
- Elyria, OH
National Provider Identifier
1811648389
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 50.008208RX
- Practice address
- 630 E River St
Elyria, OH 44035-5902 - Phone
- (440) 329-7500
- NPI assigned
- Jan 15, 2022
- Last updated
- Jul 22, 2023
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 50.008208RX | OH | Primary |
Addresses
Primary practice location
630 E River St
Elyria, OH 44035-5902
Mailing address
630 E River St
Elyria, OH 44035-5902
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50.008208RX | OH | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emh Regional Medical Center | Physician Assistant | Current | Accepting new patients |
| Baldwin Wallace University | Past | Accepting new patients |
Locations
630 E River St
Elyria, OH 44035
Phone (440) 329-7450
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.
-
dba Emergency Professional Services of Ohio, Inc.
- Emergency Medicine Physician
- Seaman, OH
- NPI 1093762353
-
dba University Hospitals Elyria Medical Center
- General Acute Care Hospital
- Elyria, OH
- NPI 1841299039
-
- Student Health Clinic/Center
- Berea, OH
- NPI 1730157272
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1642204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689984000000",
"number": "1811648389",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "630 E RIVER ST",
"city": "ELYRIA",
"state": "OH",
"postal_code": "440355902"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "630 E RIVER ST",
"city": "ELYRIA",
"state": "OH",
"postal_code": "440355902",
"telephone_number": "440-329-7500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOMBI",
"first_name": "JENNA",
"middle_name": "GRACE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-01-15",
"last_updated": "2023-07-22",
"certification_date": "2023-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OH",
"license": "50.008208RX",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elyria, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.