Individual provider Active NPI

Mary Lauretta Gilchrist

  • Family Nurse Practitioner
  • Elyria, OH
National Provider Identifier
1033940937
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.0028085 Issued in OH
Practice address
630 E River St
Elyria, OH 44035-5902
Phone
(440) 329-7500
NPI assigned
Aug 12, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.0028085 OH Primary

Addresses

Primary practice location

630 E River St
Elyria, OH 44035-5902

Mailing address

31490 Lorain Rd
North Olmsted, OH 44070-4731
Phone (440) 554-0582

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241111002360 OH Practitioner - Nurse Practitioner 1153855341 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Hospitals Medical Group IncGroup PAC ID 4789682493, 2,248 clinicians
Emh Regional Medical CenterGroup PAC ID 7517931389, 14 clinicians

Practice addresses (Care Compare)

11100 Euclid Ave
Cleveland, OH 44106-1716
Phone (216) 844-1000

630 E River St
Elyria, OH 44035-5902
Phone (440) 329-7500

Hospital & facility affiliations

  • University Hospitals - Elyria Medical Center Hospital, Elyria, OH, CCN 360145

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0028085OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emh Regional Medical Center CurrentSince Sep 22, 2024 Accepting new patients
Emh Regional Medical Center Current Accepting new patients
University Hospitals Medical Group Inc Past Accepting new patients

Locations

11100 Euclid Ave
Cleveland Heights, OH 44106

630 E River St
Elyria, OH 44035
Phone (440) 329-7450

Interoperability endpoints

  • Direct secure messaging: mgilchrist45747@ehrdirect.uhhospitals.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1723420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1033940937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31490 LORAIN RD",
            "city": "NORTH OLMSTED",
            "state": "OH",
            "postal_code": "440704731",
            "telephone_number": "440-554-0582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 E RIVER ST",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440355902",
            "telephone_number": "440-329-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILCHRIST",
        "first_name": "MARY",
        "middle_name": "LAURETTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-12",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0028085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elyria, OH

Sources for this page

Verify at the official NPI Registry.