Individual provider Active NPI

Misty Marea Richmond, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Cincinnati, OH
National Provider Identifier
1154744290
Registry record updated Jan 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
196566 Issued in OH
Practice address
6757 Tarawa Dr
Cincinnati, OH 45224-1152
Phone
(513) 931-2924
NPI assigned
Jan 24, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2016

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 196566 OH Primary

Addresses

Primary practice location

6757 Tarawa Dr
Cincinnati, OH 45224-1152

Mailing address

6757 Tarawa Dr
Cincinnati, OH 45224-1152
Phone (513) 931-2924

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
I20140310001693 OH Practitioner - Nurse Practitioner 1557591765 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Woodstream WellnessGroup PAC ID 8527462506, 55 clinicians

Practice addresses (Care Compare)

9049 Springboro Pike
Miamisburg, OH 45342-4926
Phone (937) 759-0545

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
196566OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
WS Wellness LLC Psychiatric/Mental Health CurrentSince Jan 1, 2022 Accepting new patients
Lee Side Wellness Associates, LLC Psychiatric/Mental Health CurrentSince Aug 1, 2017 Accepting new patients

Locations

1911 Old Fairfield Rd
Ste 310
Beavercreek, OH 45432
Phone (937) 759-0545

5412 Courseview Dr
Ste 215
Mason, OH 45040
Phone (513) 204-1910

3615 Socialville Foster Rd
Ste C
Mason, OH 45040
Phone (513) 204-1910

9049 Springboro Pike
Miamisburg, OH 45342
Phone (937) 759-0545

9049 Springboro Pike
Ste A
Miamisburg, OH 45342
Phone (937) 759-0545

Organizations & group practices 3

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": "1390521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453939200000",
    "number": "1154744290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6757 TARAWA DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452241152",
            "telephone_number": "513-931-2924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6757 TARAWA DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452241152",
            "telephone_number": "513-931-2924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHMOND",
        "first_name": "MISTY",
        "middle_name": "MAREA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-24",
        "last_updated": "2016-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "196566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.