JENNIFER M TANDOC NPI 1508898172

NPI Information

NPI: 1508898172
Provider Name: JENNIFER M TANDOC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
6125 N MAIN ST
DAYTON, OH
ZIP 45415
Phone: (731) 394-1145
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Jennifer M Tandoc is a family nurse practitioner in Dayton, OH with 25 years of experience. Jennifer M Tandoc NPI is 1508898172. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF CINCINNATI COLLEGE OF MEDICINE
Graduation Year:1999

The provider's business location address is:

6125 N MAIN ST
DAYTON, OH
ZIP 45415-110
Phone: (731) 394-1145

The NPI 1508898172 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/6/2006 and was last updated on 4/24/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363L00000X	Nurse Practitioner		3003193	KENTUCKY	No
2	363LF0000X	Nurse Practitioner	Family	APRN.CNP.06859	OHIO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	P00847802	OTHER	KENTUCKY	RAILROAD MEDICARE
2	3088224	MEDICAID	OHIO
3	500012750	OTHER	KENTUCKY	RAILROAD MEDICARE
4	78003720	MEDICAID	KENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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