Individual provider Active NPI

Vickie Bradley Fraser, APRN, PMHNP-BC, LPC

  • Psychiatric/Mental Health Nurse Practitioner
  • Montgomery, OH
National Provider Identifier
1104165893
Registry record updated Oct 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN.CNP.0031019 Issued in OH
Practice address
6200 Pfeiffer Rd
Montgomery, OH 45242-5862
Phone
(513) 862-4957
NPI assigned
Jan 31, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X RN.427558 OH
Critical Care Medicine Registered Nurse 163WC0200X 1150760 KY
Psychiatry Physician 2084P0800X 3017561 KY
Psychiatry Physician 2084P0800X APRN.CNP.0031019 OH
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN.CNP.0031019 OH Primary

Addresses

Primary practice location

6200 Pfeiffer Rd
Montgomery, OH 45242-5862

Mailing address

6200 Pfeiffer Rd
Montgomery, OH 45242-5862
Phone (513) 862-4957

Other practice location 1

710 Lakewood Dr
Taylor Mill, KY 41015-4408
Phone (865) 806-0943

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
I20221122001819 OH Practitioner - Nurse Practitioner 1456747708 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Trihealth H LLCGroup PAC ID 1850570458, 850 clinicians

Practice addresses (Care Compare)

375 Dixmyth Ave
Cincinnati, OH 45220-2475

379 Dixmyth Ave
Cincinnati, OH 45220-2475
Phone (513) 246-7000

6200 Pfeiffer Rd
Suite 360
Montgomery, OH 45242-5861
Phone (513) 862-4957

7810 5 Mile Rd
Cincinnati, OH 45230-2356
Phone (513) 246-7000

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1150760KYMDCritical Care Medicine Registered Nurse
RN.427558OHMDCritical Care Medicine Registered Nurse
APRN.CNP.0031019OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Trihealth H LLC CurrentSince Nov 7, 2022 Accepting new patients

Locations

4685 Forest Ave
Cincinnati, OH 45212
Phone (513) 853-4721

375 Dixmyth Ave
Ste 3135
Cincinnati, OH 45220
Phone (513) 862-3452

375 Dixmyth Ave
Cincinnati, OH 45220
Phone (513) 862-2432

6200 Pfeiffer Rd
Montgomery, OH 45242
Phone (513) 891-3373

Interoperability endpoints

  • Direct secure messaging: vfraser307676@direct.trihealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1359590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1104165893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 PFEIFFER RD",
            "city": "MONTGOMERY",
            "state": "OH",
            "postal_code": "452425862",
            "telephone_number": "513-862-4957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 PFEIFFER RD",
            "city": "MONTGOMERY",
            "state": "OH",
            "postal_code": "452425862",
            "telephone_number": "513-862-4957"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "710 Lakewood Dr",
            "address_purpose": "LOCATION",
            "city": "Taylor Mill",
            "state": "KY",
            "postal_code": "410154408",
            "country_code": "US",
            "telephone_number": "865-806-0943",
            "fax_number": "865-806-0943",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRASER",
        "first_name": "VICKIE",
        "middle_name": "BRADLEY",
        "name_prefix": "Ms.",
        "credential": "APRN, PMHNP-BC, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-31",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "OH",
            "license": "RN.427558",
            "primary": false
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "KY",
            "license": "1150760",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KY",
            "license": "3017561",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "APRN.CNP.0031019",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0031019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, OH

Sources for this page

Verify at the official NPI Registry.