Extended NP Care LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

EXTENDED NP CARE LLC

Practice address

225 Cleveland Ave
Milford, OH 45150-1099

Phone

(513) 248-1270

NPI assigned

May 7, 2018

Last updated

May 7, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kristin Elizabeth Heenan, NPNPI 1053364737

Title

Owner

Phone

(937) 544-4020

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kristin Heenan, CNP

  • Nurse Practitioner
  • Cincinnati, OH
  • NPI 1053364737
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1525651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525651200000",
    "number": "1053800847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7854 SPLIT RAIL CT",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450407982",
            "telephone_number": "513-204-2854",
            "fax_number": "937-544-4009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 CLEVELAND AVE",
            "city": "MILFORD",
            "state": "OH",
            "postal_code": "451501099",
            "telephone_number": "513-248-1270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXTENDED NP CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-07",
        "last_updated": "2018-05-07",
        "status": "A",
        "authorized_official_last_name": "HEENAN",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-544-4020",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI INDIVIDUAL",
            "identifier": "1053364737",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2693778",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Milford, OH
• Providers in Milford, OH by specialty
• Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.