Individual provider Active NPI

Jessica Stansbury

  • Nurse Practitioner
  • Toledo, OH
National Provider Identifier
1821541343
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN.CNP.0028705 Issued in OH
Practice address
2142 N Cove Blvd # 201
Toledo, OH 43606-3895
Phone
(419) 291-1111
Fax
(419) 479-3253
NPI assigned
Aug 2, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R46533 ND
Nurse Practitioner 363L00000X 4704289812 MI
Nurse Practitioner 363L00000X APRN.CNP.0028705 OH Primary

Addresses

Primary practice location

2142 N Cove Blvd # 201
Toledo, OH 43606-3895

Mailing address

333 N Summit St FL 7
Toledo, OH 43604-1531
Phone (419) 291-1111

Other practice location 1

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Phone (248) 898-5058

Other practice location 2

5225 23rd Ave S
Fargo, ND 58104
Phone (701) 417-2575

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions
Direct Messaging Address jstansbury217496@epicdirect.promedica.org

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
I20210525003104 OH Practitioner - Nurse Practitioner 2062706419 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Michigan Medical School, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians

Practice addresses (Care Compare)

2142 N Cove Blvd
Toledo, OH 43606-3895
Phone (419) 291-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R46533NDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians CurrentSince May 1, 2021 Accepting new patients
Promedica Central Physicians Nurse Practitioner CurrentSince May 1, 2021 Accepting new patients

Locations

333 N Summit St
Fl 7
Toledo, OH 43604
Phone (419) 252-5909

2142 N Cove Blvd
#201
Toledo, OH 43606
Phone (419) 291-1111

100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964

2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111

2130 W Central Ave
Ste 105
Toledo, OH 43606
Phone (419) 291-4590

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

Interoperability endpoints

  • Direct secure messaging: jstansbury217496@direct.promedica.org

Organizations & group practices 2

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.

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": "1470096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1821541343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SUMMIT ST FL 7",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041531",
            "telephone_number": "419-291-1111",
            "fax_number": "419-479-3253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2142 N COVE BLVD # 201",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436063895",
            "telephone_number": "419-291-1111",
            "fax_number": "419-479-3253"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 W 13 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Royal Oak",
            "state": "MI",
            "postal_code": "480736712",
            "country_code": "US",
            "telephone_number": "248-898-5058",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5225 23rd Ave S",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "58104",
            "country_code": "US",
            "telephone_number": "701-417-2575",
            "fax_number": "701-417-2535",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STANSBURY",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-02",
        "last_updated": "2023-11-03",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ND",
            "license": "R46533",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704289812",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.0028705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jstansbury217496@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.