Jacquelyn M Dennis, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

COA.18811-NP Issued in OH

Practice address

1207 W State St
Suite N
Alliance, OH 44601-4686

Phone

(330) 821-3244

Fax

(330) 868-5782

NPI assigned

Feb 26, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

University of Cincinnati College of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Manor Management Company IncGroup PAC ID 7012911209, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Alliance Community Hospital Hospital, Alliance, OH, CCN 360131

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jacquelyn.dennis.1@2706.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/2706/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• FHIR API: https://api.platform.athenahealth.com/22081/brand/1/csg/1/fhir/r4

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.

• Manor Management Company Inc

  • Internal Medicine Physician
  • Alliance, OH
  • NPI 1639194483
  Medicare reassignment Care Compare group NPD
• Paragon Heart Group, Inc

  • Cardiovascular Disease Physician
  • Alliance, OH
  • NPI 1932372398
  NPD
• Neurocare Sleep Center

  • Neurology Physician
  • Canton, OH
  • NPI 1407180144
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Alliance Community Hospital

  • General Acute Care Hospital
  • Alliance, OH
  • NPI 1942385794
  Care Compare affiliation

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

{
    "created_epoch": "1456444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490832000000",
    "number": "1982064432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 W STATE ST",
            "address_2": "SUITE N",
            "city": "ALLIANCE",
            "state": "OH",
            "postal_code": "446014686",
            "telephone_number": "330-821-3244",
            "fax_number": "330-868-5782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 W STATE ST",
            "address_2": "SUITE N",
            "city": "ALLIANCE",
            "state": "OH",
            "postal_code": "446014686",
            "telephone_number": "330-821-3244",
            "fax_number": "330-868-5782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNIS",
        "first_name": "JACQUELYN",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-26",
        "last_updated": "2017-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA.18811-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168552",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• McKenna Judith Deible
• Cory Delaney, ATC, LAT
• Dellagatta Dental
• Monica Berkemeier Delmedico, PA-C
• Megan Ann Demos, MSN, PMHNP-BC
• Claudio A Deperalta, MD
• Joseph Evan Devillier, MD
• Sanjeev Dewan, M.D.
• Gagandeep Kaur Dhaliwal, PA
• Jean D Dib, M.D.

• Family Nurse Practitioner in Alliance, OH
• Providers in Alliance, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.