Individual provider Active NPI

Jaclyn Ann Grope, NP

  • Family Nurse Practitioner
  • Poland, OH
National Provider Identifier
1932746880
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.025498 Issued in OH
Practice address
715 E Western Reserve Rd
Poland, OH 44514-3358
Phone
(330) 726-3204
Fax
(330) 729-9316
NPI assigned
Dec 10, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X APRN.CNP.025498 OH
Family Nurse Practitioner 363LF0000X APRN.CNP.025498 OH Primary

Addresses

Primary practice location

715 E Western Reserve Rd
Poland, OH 44514-3358

Mailing address

715 E Western Reserve Rd
Poland, OH 44514-3358
Phone (330) 726-3204

Other practice location 1

627 Eastland Ave SE Ste 301
Warren, OH 44484-4501
Phone (330) 392-3099

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
I20200131002249 OH Practitioner - Nurse Practitioner 7911333448 Reassigns benefits to 3 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
Mercy Health Physicians Youngstown Specialty Care LLCGroup PAC ID 3476950296, 463 clinicians

Practice addresses (Care Compare)

715 E Western Reserve Rd
Poland, OH 44514-3358
Phone (330) 726-3204

Hospital & facility affiliations

  • MH St Elizabeth Youngstown Hospital Hospital, Youngstown, OH, CCN 360064

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CNP.025498OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Nov 19, 2023 Accepting new patients
Inpatient Medical Services, Inc. CurrentSince Jan 8, 2020 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC Cardiovascular Disease Current Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Nov 19, 2023 Accepting new patients
4M Hospitalist Services, LLC CurrentSince Jan 1, 2021 Accepting new patients
Ohio CVS Stores, L.L.C. PastSince Apr 1, 2021 Accepting new patients

Locations

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

29 N Adams St
Akron, OH 44304
Phone (330) 572-7293

141 N Forge St
Akron, OH 44304
Phone (330) 375-3361

410 W 10th Ave
Columbus, OH 43210
Phone (614) 293-5905

3557 Embassy Pkwy
Fairlawn, OH 44333
Phone (330) 670-1005

1290 Fairchild Ave
Kent, OH 44240
Phone (330) 678-4912

6847 N Chestnut St
Ravenna, OH 44266
Phone (330) 296-9606

627 Eastland Ave SE
Ste 301
Warren, OH 44484
Phone (330) 392-3099

715 E Western Reserve Rd
Youngstown, OH 44514
Phone (330) 726-3204

Interoperability endpoints

  • Direct secure messaging: jgrope702423@direct.bsmhealth.org

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.

Hospital & facility affiliations 2

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": "1575936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1932746880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 E WESTERN RESERVE RD",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445143358",
            "telephone_number": "330-726-3204",
            "fax_number": "330-729-9316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 E WESTERN RESERVE RD",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445143358",
            "telephone_number": "330-726-3204",
            "fax_number": "330-729-9316"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "627 Eastland Ave SE Ste 301",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "OH",
            "postal_code": "444844501",
            "country_code": "US",
            "telephone_number": "330-392-3099",
            "fax_number": "330-395-1721",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROPE",
        "first_name": "JACLYN",
        "middle_name": "ANN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-10",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "APRN.CNP.025498",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.025498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poland, OH

Sources for this page

Verify at the official NPI Registry.