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

Jessica L Blank

Individual provider Nurse Practitioner · NPI 1386420313

Jessica L Blank is a Nurse Practitioner in Beavercreek, Ohio. Qualified in 2023, 3 years ago. Practices with Summit Medical Group Inc, a 799-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Kentucky and Ohio.

Years since qualifying
3
Licensed in
KY, OH
In the registry since
2023
Specialties on file
2
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Practice location Address checks out

3535 Pentagon Blvd
Beavercreek, OH 45431-1705
Phone: (937) 395-6665
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1 Medical Village Dr, Edgewood, KY 41017-3403 — (859) 757-2927
  • 1 Medical Village Dr, Edgewood, KY 41017 — (859) 301-2250

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence APRN.CNP.0038855 (OH)
Nurse Practitioner Taxonomy 363L00000X · Licence 4007154 (KY)

Record details

NPI number1386420313
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 6, 2023
Last updated in NPPESApril 30, 2025
Certification dateApril 30, 2025
Mailing addressPo Box 638685, Cincinnati, OH 45263-5283

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Summit Medical Group Inc — 799 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare

Other providers in Beavercreek