Individual provider Active NPI

Larisha Nicole Martin, FNP-C

  • Family Nurse Practitioner
  • Cincinnati, OH
National Provider Identifier
1063206712
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0041549 Issued in OH
Practice address
5488 Childs Ave
Cincinnati, OH 45248-5206
Phone
(864) 401-2489
NPI assigned
Apr 8, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 552725 OH
Family Nurse Practitioner 363LF0000X 0041549 OH Primary

Addresses

Primary practice location

5488 Childs Ave
Cincinnati, OH 45248-5206

Mailing address

5488 Childs Ave
Cincinnati, OH 45248-5206
Phone (864) 401-2489

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
I20260408003702 OH Practitioner - Nurse Practitioner 4587139423 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2026
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CG Medical Associates IncGroup PAC ID 6608052196, 171 clinicians

Practice addresses (Care Compare)

360 Glensprings Dr
Springdale, OH 45246-2304
Phone (513) 671-5050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
552725OHMDRegistered Nurse
0041549OHMDFamily Nurse Practitioner

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1744070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1063206712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5488 CHILDS AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452485206",
            "telephone_number": "864-401-2489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5488 CHILDS AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452485206",
            "telephone_number": "864-401-2489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "LARISHA",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-08",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "552725",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "0041549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.