NICOLE JEDERLINIC (NPI# 1598185191) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598185191 |
| Entity Type | Individual |
| Full Name | NICOLE JEDERLINIC |
| Credential | D.O. |
| Practice Address |
4075 Old Western Row Rd Mason OH 45040-3104 |
| Practice Telephone | 5135360254 |
| Practice Fax Number | 5135360609 |
| Mailing Telephone | 5135360232 |
| Mailing Fax Number | 5135360609 |
| Enumeration Date | 2014-04-22 |
| Last Update Date | 2019-08-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
34.012476 | OH | Allopathic & Osteopathic Physicians |
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
34.012476 | OH | Allopathic & Osteopathic Physicians |
| Street Address |
4075 OLD WESTERN ROW RD |
| City | MASON |
| State | OH |
| Zip Code | 45040-3104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891793220 | Carol Blankemeyer Dewald | Registered Nurse | 4075 Old Western Row Rd, Mason, OH 45040-3104 | 2005-07-11 |
| 1477171346 | Kimberly Spivey | Registered Nurse | 4075 Old Western Row Rd, Mason, OH 45040-3104 | 2020-07-08 |
| 1154989663 | Jessica Lynn Kraft | Nurse Practitioner | 4075 Old Western Row Rd, Mason, OH 45040-3104 | 2019-05-30 |
| 1447816905 | Allison Mecca | Psychologist | 4075 Old Western Row Rd, Mason, OH 45040-3104 | 2019-05-10 |
| 1407353618 | Erin Catherine Snider | Nurse Practitioner | 4075 Old Western Row Rd, Mason, OH 45040 | 2018-04-12 |
| 1356849384 | Stephanie Paige Kisling | Case Manager/Care Coordinator | 4075 Old Western Row Rd, Mason, OH 45040-3104 | 2018-01-24 |
| 1982127122 | Danielle Beltz | Nurse Practitioner | 4075 Old Western Row Rd, Mason, OH 45040-3104 | 2017-07-19 |
| 1023539517 | Anna Ward | Registered Nurse | 4075 Old Western Row Rd, Mason, OH 45040-3104 | 2017-07-05 |
| 1912433574 | Jennifer Milau | Registered Nurse | 4075 Old Western Row Rd, Mason, OH 45040-3104 | 2017-05-02 |
| 1215476767 | Jennifer B Wilcox | Psychologist | 4075 Old Western Row Rd, Mason, OH 45040-3104 | 2017-02-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336633882 | Jarek Beegan | Specialist/Technologist, Other | 8188 Corporate Way, Mason, OH 45040 | 2018-06-19 |
| 1548771439 | Jeanene Gibson | Registered Nurse | 9945 Coventry Court, Mason, OH 45040 | 2017-10-18 |
| 1093249898 | Peace of Mind Care Services, Inc. | Community/Behavioral Health | 5180 Cedar Village Drive, Suite A, Mason, OH 45040 | 2017-04-18 |
| 1477938736 | Justin William Florek | Chiropractor | 6213 Snider Road, Mason, OH 45040 | 2015-07-28 |
| 1730562729 | Alexandra Courts | Physical Therapist | 5267 Joseph Ln, Mason, OH 45040 | 2015-07-08 |
| 1982083531 | Nicole Roether | Specialist/Technologist | 5236 Socialville-foster Road, Mason, OH 45040 | 2015-05-28 |
| 1568849123 | Alissa Marie Conde | Pediatrics | 9560 Children's Drive, Mason, OH 45040 | 2015-05-04 |
| 1205220696 | Elizabeth Barnes | Pain Medicine | 3611 Socialville-foster Rd, Suite 101, Mason, OH 45040 | 2015-03-24 |
| 1669864807 | Lang Truong | Pharmacist | 5542 Red Fox Ct, Mason, OH 45040 | 2015-02-25 |
| 1295133668 | Gregory Carr | Psychologist | 4569 Wesley Ct, Mason, OH 45040 | 2014-12-16 |
| Find all providers in zip 45040 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659562965 | Jennifer Lynn Shoenfelt | Psychiatry & Neurology | 4075 Old Western Row Rd, Mason, OH 45040-3104 | 2007-08-05 |
| 1902982515 | Suzanne Sumida | Psychiatry & Neurology | 4075 Old Western Row Rd, Mason, OH 45040-3104 | 2006-10-27 |
| 1154432649 | Tracy Suzanne Cummings | Psychiatry & Neurology | 4075 Old Western Row Rd, Mason, OH 45040-3104 | 2006-08-31 |
| 1942318290 | Charles Stephen Edwards | Psychiatry & Neurology | 4075 Old Western Row Rd, Lindner Center of Hope, Mason, OH 45040-3104 | 2006-08-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669882890 | Nimisha Paul Thuluvath | Psychiatry & Neurology | 601 S Edwin Moses Blvd, Dayton, OH 45417-3424 | 2014-04-28 |
| 1467896142 | Erin Campbell Fulchiero | Psychiatry & Neurology | 551 East Washington St., Chagrin Falls, OH 44022 | 2013-04-24 |
| 1578820452 | Sree Latha Krishna Jadapalle | Psychiatry & Neurology | 11395 Cheyenne Trail, Apt 101, Parma Heights, OH 44130 | 2012-04-18 |
| 1801180401 | Brio Neurobehavioral Consultants | Psychiatry & Neurology | 3567 Reserve Commons Dr, Suite 125, Medina, OH 44256-5323 | 2011-06-01 |
| 1477861862 | Stacy A Solheim | Psychiatry & Neurology | Wright Patterson Medical Center - 88 Mdos/sgow, 4881 Sugar Maple Ave, Wpafb, OH 45433-5529 | 2010-09-20 |
| 1841506763 | Jackosky Health Inc | Psychiatry & Neurology | 30400 Detroit Rd Ste 404, Westlake, OH 44145-1855 | 2010-08-30 |
| 1467768531 | Jillian Alexis Shellabarger | Psychiatry & Neurology | 1522 E Us Highway 36, Urbana, OH 43078-9738 | 2010-08-26 |
| 1538321062 | Deborah Amann | Psychiatry & Neurology | 9403 Kenwood Rd Ste B120, Blue Ash, OH 45242-6884 | 2008-06-26 |
| 1154597839 | Aditi M Sheth | Psychiatry & Neurology | 2720 Sweetwater Dr, Brecksville, OH 44141-4101 | 2008-05-02 |
| 1699970608 | Family & Youth Institute | Psychiatry & Neurology | 14 Sandalwood Drive, Newark, OH 43055 | 2007-06-19 |
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| 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.