JENNIFER M TANDOC (NPI# 1508898172) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508898172 |
| Entity Type | Individual |
| Full Name | JENNIFER M TANDOC |
| Practice Address |
6125 N Main St Dayton OH 45415-3110 |
| Mailing Address |
36 Pemberton Cv Jackson TN 38305-5514 |
| Practice Telephone | 7313941145 |
| Mailing Telephone | 7313941145 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2020-04-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 3003193 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
APRN.CNP.06859 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | RAILROAD MEDICARE | P00847802 | 01 |
| OH | 3088224 | 05 | |
| KY | RAILROAD MEDICARE | 500012750 | 01 |
| KY | 78003720 | 05 |
| Street Address |
6125 N MAIN ST |
| City | DAYTON |
| State | OH |
| Zip Code | 45415-3110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245732247 | Sandra K Miller | Occupational Therapist | 6125 N Main St, Dayton, OH 45415-3110 | 2018-03-06 |
| 1154823706 | Heather Ann Ring X | Physical Therapist | 6125 N Main St, Dayton, OH 45415-3110 | 2018-02-28 |
| 1407357338 | Brittany Nichole Swint | Speech-Language Pathologist | 6125 N Main St, Dayton, OH 45415-3110 | 2018-02-26 |
| 1023475639 | Alisha M Holman | Occupational Therapist | 6125 N Main St, Dayton, OH 45415-3110 | 2016-01-27 |
| 1528425352 | Kaitlynn Romanello | Speech-Language Pathologist | 6125 N Main St, Dayton, OH 45415-3110 | 2016-01-25 |
| 1215314497 | Diversicare of Seina Woods, LLC | Assisted Living Facility | 6125 N Main St, Dayton, OH 45415-3110 | 2015-04-27 |
| 1952736779 | Diversicare of Siena Woods, LLC | Skilled Nursing Facility | 6125 N Main St, Dayton, OH 45415-3110 | 2013-09-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457881062 | Angelique Oluyitan | Registered Nurse | 50 Granite Dr, Dayton, OH 45415 | 2017-06-15 |
| 1255869244 | Sherry Marie Buchanan | Occupational Therapy Assistant | 140 Ewoodbury Dr, Dayton, OH 45415 | 2017-06-02 |
| 1417328972 | Thomas Riddell | Hearing Instrument Specialist | 5525 N. Main St, Dayton, OH 45415 | 2015-10-09 |
| 1932448537 | Mory Summer | General Practice | 141 Trailwoods Dr., Dayton, OH 45415 | 2013-02-04 |
| 1184909095 | Yolanda Jean Jenkins | Registered Nurse | 6339 Afton Drive, Dayton, OH 45415 | 2011-10-12 |
| 1023392560 | Megan E Betts | Specialist/Technologist, Other | 9000 N Main St. Ste 303, Dayton, OH 45415 | 2011-10-03 |
| 1356655195 | Gwendolyn L. Warren | Massage Therapist | 8393 N. Main St., Ste B, Dayton, OH 45415 | 2010-08-04 |
| 1811141559 | Dayton Physicians, LLC | Durable Medical Equipment & Medical Supplies | 9000 N Main St Suite 333, Dayton, OH 45415 | 2008-11-07 |
| 1730331224 | Joel Metze | Obstetrics & Gynecology | 9000 N Main St Ste 232, Englewood, OH 45415 | 2008-10-16 |
| 1023236247 | James Otis Hurst | Dentist | 9000 N. Main Street, Suite 207, Dayton, OH 45415 | 2007-04-23 |
| Find all providers in zip 45415 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316546740 | Kristen Avery Weaver | Nurse Practitioner | 322 High St, Dayton, VA 22821-9548 | 2020-10-17 |
| 1760094155 | Amanda Kenney | Nurse Practitioner | 5619 Hugh Dr, Dayton, OH 45459-1618 | 2020-08-18 |
| 1295371177 | Sophia Arnold | Nurse Practitioner | 5242 Rucks Rd, Dayton, OH 45417-8221 | 2019-11-26 |
| 1811548092 | April Nicole Peveto | Nurse Practitioner | 101 S Prairie St, Dayton, TX 77535-2819 | 2019-09-27 |
| 1659925253 | Marian Kimara Doukoure | Nurse Practitioner | 2615 Wayne Ave, Dayton, OH 45420-1833 | 2019-07-31 |
| 1396200523 | Robert Andre De Roziere Jr. | Nurse Practitioner | Maria Joseph Care Center, 4780 Salem Avenue, Dayton, OH 45416 | 2019-02-01 |
| 1255804795 | Kathlene Jacoby | Nurse Practitioner | 7700 Washington Village Dr Ste 230, Dayton, OH 45459-4094 | 2019-01-08 |
| 1952878811 | Kenneth Howard | Nurse Practitioner | 101 S Prairie St Ste D, Dayton, TX 77535-2819 | 2018-10-30 |
| 1053895789 | Lori Bickett | Nurse Practitioner | 33 W Rahn Rd # 102, Dayton, OH 45429-2219 | 2018-09-19 |
| 1720571193 | Shelby Herbst | Nurse Practitioner | 7076 Corporate Way Ste 201, Dayton, OH 45459-4246 | 2018-06-11 |
| Find all providers in DAYTON | ||||
Please comment or provide details below to improve the information on JENNIFER M TANDOC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.