Individual provider Active NPI

Latonia Yvette Cushingberry, FNP

  • Family Nurse Practitioner
  • Fairfield, OH
National Provider Identifier
1104200716
Registry record updated Jul 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F07155500 Issued in OH
Practice address
154 Twin Lakes Dr
Fairfield, OH 45014-5257
Phone
(513) 628-0627
NPI assigned
Jul 13, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2015

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 F07155500 OH Primary

Addresses

Primary practice location

154 Twin Lakes Dr
Fairfield, OH 45014-5257

Mailing address

154 Twin Lakes Dr
Fairfield, OH 45014-5257
Phone (513) 628-0627

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
I20230829000450 OH Practitioner - Nurse Practitioner 8628376563 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
National Youth Advocate Program IncGroup PAC ID 7719258292, 22 clinicians

Practice addresses (Care Compare)

11156 Canal Rd
Suite a
Cincinnati, OH 45241-5816
Phone (513) 772-6166

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F07155500OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
National Youth Advocate Program, Inc CurrentSince Jun 17, 2023 Accepting new patients
National Youth Advocate Program, Inc CurrentSince Jun 17, 2023 Accepting new patients

Locations

527 S High St
Columbus, OH 43215
Phone (614) 227-9444

1801 Watermark Dr
Ste 200
Columbus, OH 43215

11156 Canal Rd
Ste A
Sharonville, OH 45241
Phone (513) 772-6166

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20912/brand/1/csg/1/fhir/r4

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1436745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436745600000",
    "number": "1104200716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "154 TWIN LAKES DR",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450145257",
            "telephone_number": "513-628-0627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 TWIN LAKES DR",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450145257",
            "telephone_number": "513-628-0627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSHINGBERRY",
        "first_name": "LATONIA",
        "middle_name": "YVETTE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-13",
        "last_updated": "2015-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "F07155500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, OH

Sources for this page

Verify at the official NPI Registry.