NPIMap

Individual provider Active NPI

Jaclyn Rose Geddes, CNP

  • Gerontology Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1861053639
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN.CNP.025203 Issued in OH
Practice address
3535 Olentangy River Rd
Columbus, OH 43214-3908
Phone
(614) 262-6772
Fax
(614) 533-0162
NPI assigned
Jun 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X APRN.CNP.025203 OH Primary

Addresses

Primary practice location

3535 Olentangy River Rd
Columbus, OH 43214-3908

Mailing address

PO Box 7527
Dublin, OH 43017-0727

Other practice location 1

4437 State Route 159 Ste 125
Chillicothe, OH 45601-7065
Phone (740) 779-4570

Other identifiers 1

IdentifierTypeStateIssuer
0361695MedicaidOH

Other names 1

  • Jaclyn Rose Wuebold Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address adena.cardio@adena.medicity.net
Direct Messaging Address jwuebold12827@direct.ohiohealth.com OhioHealth Physician Group, Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190829002065 OH Practitioner - Nurse Practitioner 9133457039 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohiohealth CorporationGroup PAC ID 6305758426, 2,295 clinicians

Practice addresses (Care Compare)

3535 Olentangy River Rd
Columbus, OH 43214-3908
Phone (614) 566-2934

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.93 of 100Reported as group
Quality
64.42
Promoting interoperability
99
Improvement activities
40
Cost
73.2

Merit-based Incentive Payment System (MIPS)

Final score
80.04 of 100Reported as group
Quality
58.67
Promoting interoperability
98
Improvement activities
40
Cost
76.46

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Adena Medical Group LLC CurrentSince Aug 12, 2019 Accepting new patients
Ohiohealth Corporation CurrentSince Jul 1, 2024 Accepting new patients
Ohiohealth Corporation CurrentSince Jul 1, 2024 Accepting new patients
Ohiohealth Corporation Current Accepting new patients

Locations

4437 State Route 159
Ste 125
Chillicothe, OH 45601
Phone (740) 779-4570

272 Hospital Rd
Chillicothe, OH 45601
Phone (740) 779-4275

3535 Olentangy River Rd
Columbus, OH 43214
Phone (614) 566-1997

Dept L3652
Columbus, OH 43260

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

12340 State Route 104
Waverly, OH 45690
Phone (740) 941-5180

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 and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1861053639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7527",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430170727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 OLENTANGY RIVER RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432143908",
            "telephone_number": "614-262-6772",
            "fax_number": "614-533-0162"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4437 State Route 159 Ste 125",
            "address_purpose": "LOCATION",
            "city": "Chillicothe",
            "state": "OH",
            "postal_code": "456017065",
            "country_code": "US",
            "telephone_number": "740-779-4570",
            "fax_number": "740-779-4579",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GEDDES",
        "first_name": "JACLYN",
        "middle_name": "ROSE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-24",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OH",
            "license": "APRN.CNP.025203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0361695",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adena.cardio@adena.medicity.net",
            "affiliation": "N",
            "address_1": "4437 State Route 159 Ste 125",
            "city": "Chillicothe",
            "state": "OH",
            "country_code": "US",
            "postal_code": "456017065",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwuebold12827@direct.ohiohealth.com",
            "affiliation": "Y",
            "affiliationName": "OhioHealth Physician Group, Inc.",
            "address_1": "3535 Olentangy River Rd",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432143908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JACLYN",
            "last_name": "WUEBOLD",
            "middle_name": "ROSE",
            "credential": "BSN, RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.