Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jacqueline L Roethlisberger, NP

Individual provider Adult Health Nurse Practitioner · NPI 1366561870

Jacqueline L Roethlisberger, NP is a Nurse Practitioner in Kettering, Ohio. Qualified in 1996, 30 years ago. Practices with Kettering Independent Medical Group Inc, a 700-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Ohio.

Years since qualifying
30
Licensed in
OH
In the registry since
2007
Specialties on file
2
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

3700 Southern Blvd Ste 201
Kettering, OH 45429-1265
Phone: (855) 500-2873
Fax: (937) 281-3992
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence COA 03334 NP (OH)
Adult Health Nurse Practitioner Taxonomy 363LA2200X · Licence RN 199132 COA (OH)

Record details

NPI number1366561870
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorNo
NPI enumeratedMarch 28, 2007
Last updated in NPPESApril 12, 2022
Certification dateApril 12, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 1996 (30 years in practice)
Group practice Kettering Independent Medical Group Inc — 700 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

Other providers in Kettering