Individual provider Active NPI

Michael Tollison, CNP

  • Family Nurse Practitioner
  • Cincinnati, OH
National Provider Identifier
1154082725
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP.0036262 Issued in OH
Practice address
4613 Marburg Ave
Cincinnati, OH 45209-5005
Phone
(513) 782-5060
NPI assigned
Jan 6, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4018491 KY
Family Nurse Practitioner 363LF0000X CNP.0036262 OH Primary

Addresses

Primary practice location

4613 Marburg Ave
Cincinnati, OH 45209-5005

Mailing address

PO Box 932958
Cleveland, OH 44193-0028

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
I20241203003683 OH Practitioner - Nurse Practitioner 9739615527 Reassigns benefits to 1 organization

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
The Little Clinic of Ohio LLCGroup PAC ID 7719087584, 212 clinicians

Practice addresses (Care Compare)

4613 Marburg Ave
Cincinnati, OH 45209-5005
Phone (513) 782-5060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4018491KYMDFamily Nurse Practitioner
CNP.0036262OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Little Clinic of Ohio LLC Family CurrentSince Dec 26, 2024 Accepting new patients

Locations

4613 Marburg Ave
Cincinnati, OH 45209
Phone (513) 782-5060

199 Graceland Blvd
Columbus, OH 43214
Phone (614) 410-2814

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": "1641427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1154082725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 932958",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4613 MARBURG AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452095005",
            "telephone_number": "513-782-5060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLLISON",
        "first_name": "MICHAEL",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-06",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "4018491",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "CNP.0036262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.