Individual provider Active NPI

Jessica M Lauderman, MSN, FNP-C

  • Nurse Practitioner
  • Cincinnati, OH
National Provider Identifier
1891386751
Registry record updated Sep 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN.CNP.026631 Issued in OH
Practice address
3333 Burnet Ave, ML 5021
Cincinnati, OH 45229-3039
Phone
(513) 636-4611
NPI assigned
Feb 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.026631 OH
Nurse Practitioner 363L00000X APRN.CNP.026631 OH Primary

Addresses

Primary practice location

3333 Burnet Ave, ML 5021
Cincinnati, OH 45229-3039

Mailing address

3333 Burnet Ave, ML 2023
Cincinnati, OH 45229-3026
Phone (513) 636-4371

Other practice location 1

560 Wessel Dr
Fairfield, OH 45014-3776
Phone (513) 858-8200

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
I20210209002852 OH Practitioner - Nurse Practitioner 8325453103 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Children'S Hospital Medical Center 716 clinicians

Practice addresses (Care Compare)

3333 Burnet Ave
Cincinnati, OH 45229-3026
Phone (513) 636-4200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
APRN.CNP.026631OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Little Clinic of Ohio LLC Family CurrentSince Feb 17, 2021 Accepting new patients
Children'S Hospital Medical Center Nurse Practitioner CurrentSince Aug 11, 2022 Accepting new patients

Locations

3341 Solutions Ctr
Chicago, IL 60677

4315 Ivy Pointe Blvd
Cincinnati, OH 45245
Phone (513) 636-0030

3333 Burnet Ave
#5021
Cincinnati, OH 45229
Phone (513) 636-4225

3333 Burnet Ave
Cincinnati, OH 45229
Phone (513) 636-4200

7580 Beechmont Ave
Cincinnati, OH 45255
Phone (513) 233-4420

3333 Burnet Ave
#2023
Cincinnati, OH 45229
Phone (513) 636-4200

199 Graceland Blvd
Columbus, OH 43214
Phone (614) 410-2814

560 Wessel Dr
Fairfield, OH 45014
Phone (513) 454-2084

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1612224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662249600000",
    "number": "1891386751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE, ML 2023",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293026",
            "telephone_number": "513-636-4371",
            "fax_number": "513-636-7657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE, ML 5021",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293039",
            "telephone_number": "513-636-4611"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "560 Wessel Dr",
            "address_purpose": "LOCATION",
            "city": "Fairfield",
            "state": "OH",
            "postal_code": "450143776",
            "country_code": "US",
            "telephone_number": "513-858-8200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAUDERMAN",
        "first_name": "JESSICA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "MSN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-02",
        "last_updated": "2022-09-04",
        "certification_date": "2022-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.026631",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.026631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.