Individual provider Active NPI

Ernest Siaw Obeng

  • Psychiatric/Mental Health Nurse Practitioner
  • Fairfield, OH
National Provider Identifier
1083139620
Registry record updated Dec 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN.CNP.0035492 Issued in OH
Practice address
5808 Red Oak Dr
Fairfield, OH 45014-3577
Phone
(513) 546-6491
NPI assigned
Aug 4, 2017
Last updated
Dec 22, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN.CNP.0035492 OH Primary

Addresses

Primary practice location

5808 Red Oak Dr
Fairfield, OH 45014-3577

Mailing address

5808 Red Oak Dr
Fairfield, OH 45014-3577
Phone (513) 546-6491

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
I20240403002922 OH Practitioner - Nurse Practitioner 9537507074 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

525 Metro PL N
Suite 300
Dublin, OH 43017-5320
Phone (855) 289-1722

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0035492OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health, LLC CurrentSince Apr 15, 2024 Accepting new patients

Locations

175 S 3rd St
Ste 200
Columbus, OH 43215
Phone (267) 817-8902

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

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": "1501804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703203200000",
    "number": "1083139620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5808 RED OAK DR",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450143577",
            "telephone_number": "513-546-6491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5808 RED OAK DR",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450143577",
            "telephone_number": "513-546-6491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBENG",
        "first_name": "ERNEST",
        "middle_name": "SIAW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-04",
        "last_updated": "2023-12-22",
        "certification_date": "2023-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0035492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, OH

Sources for this page

Verify at the official NPI Registry.