Individual provider Active NPI

Daniel Michael Ross Jr., APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1134976558
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN.CNP.0036147 Issued in OH
Practice address
21 E State St
Columbus, OH 43215-4281
Phone
(574) 546-1900
Fax
(574) 546-1999
NPI assigned
May 3, 2024
Last updated
Jun 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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.0036147 OH Primary

Addresses

Primary practice location

21 E State St
Columbus, OH 43215-4281

Mailing address

PO Box 11167
Fort Wayne, IN 46856-1167
Phone (574) 546-1900

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
I20240717004560 OH Practitioner - Nurse Practitioner 9335684026 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
Group practices
Guidestar Eldercare Corp -OhGroup PAC ID 9739504523, 43 clinicians

Practice addresses (Care Compare)

2026 State Route 45
Austinburg, OH 44010-9711
Phone (574) 546-1900

990 Bayley Dr
Cincinnati, OH 45233-1664
Phone (574) 546-1900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Guidestar Eldercare Corp -Oh Nurse Practitioner CurrentSince May 17, 2024 Accepting new patients

Locations

990 Bayley Dr
Cincinnati, OH 45233
Phone (513) 347-5500

21 E State St
Columbus, OH 43215
Phone (574) 546-1999

214 Harding St
Defiance, OH 43512
Phone (419) 784-1014

31054 State Route 93
Mc Arthur, OH 45651
Phone (732) 691-0470

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, 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": "1714694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1134976558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11167",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468561167",
            "telephone_number": "574-546-1900",
            "fax_number": "574-546-1999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 E STATE ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432154281",
            "telephone_number": "574-546-1900",
            "fax_number": "574-546-1999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "DANIEL",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-03",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0036147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.