Individual provider Active NPI

Gloria Amissah, APRN-PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1124854260
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0037536 Issued in OH
Practice address
3664 Revolutionary Dr
Columbus, OH 43207-6535
Phone
(614) 805-8313
NPI assigned
Sep 13, 2024
Last updated
Jul 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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 0037536 OH Primary

Addresses

Primary practice location

3664 Revolutionary Dr
Columbus, OH 43207-6535

Mailing address

665 E Dublin Granville Rd
Columbus, OH 43229-3245
Phone (614) 805-8313

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4995 Bradenton Ave
Suite 110
Dublin, OH 43017-3525

4995 Bradenton Ave
Suite 110
Dublin, OH 43017-3551

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0037536OHMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1726185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1124854260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 E DUBLIN GRANVILLE RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432293245",
            "telephone_number": "614-805-8313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3664 REVOLUTIONARY DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432076535",
            "telephone_number": "614-805-8313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMISSAH",
        "first_name": "GLORIA",
        "credential": "APRN-PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-13",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "0037536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.