Provider Demographics
NPI:1013997170
Name:KESSINGER, JODI (OD)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:
Last Name:KESSINGER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2740 NAVARRE AVE
Mailing Address - Street 2:
Mailing Address - City:OREGON
Mailing Address - State:OH
Mailing Address - Zip Code:43616-3216
Mailing Address - Country:US
Mailing Address - Phone:419-693-4444
Mailing Address - Fax:419-697-2149
Practice Address - Street 1:2740 NAVARRE AVE
Practice Address - Street 2:
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616
Practice Address - Country:US
Practice Address - Phone:419-693-4444
Practice Address - Fax:419-697-2149
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH.4655152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH412029328033OtherCARESOURCE
OH4655OtherOHIO LICENSE
OH000000231248OtherBCBS
OH03213OtherPARAMOUNT HEALTH CARE
OH5996621OtherAETNA
OH2100505Medicaid
OH728542OtherBUCKEYE
OH2101650OtherUNITED HEALTH CARE
OH5996621OtherAETNA
OH$$$$$$$$$007OtherMEDICAL MUTUAL OF OHIO
OH$$$$$$$$$010OtherMEDICAL MUTUAL OF OHIO
OH412029328033OtherCARESOURCE
OH4655OtherOHIO LICENSE
OH4082241Medicare PIN
OH000000231248OtherBCBS
OH728542OtherBUCKEYE
OH4655OtherOHIO LICENSE
OH2101650OtherUNITED HEALTH CARE
OHU64701Medicare UPIN
OHH465032Medicare PIN
OH5996621OtherAETNA
OH$$$$$$$$$012OtherMEDICAL MUTUAL OF OHIO
OHP00432555Medicare PIN