Individual provider Active NPI

Jason Vincent Guevara, CNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Mason, OH
National Provider Identifier
1174055529
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN.CNP.0029442 Issued in OH
Practice address
5386 Cox Smith Rd Ste a
Mason, OH 45040-6803
Phone
(216) 468-5000
NPI assigned
Apr 3, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 434495 OH
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN.CNP.0029442 OH Primary

Addresses

Primary practice location

5386 Cox Smith Rd Ste a
Mason, OH 45040-6803

Mailing address

4800 N Scottsdale Rd Ste 2500
Scottsdale, AZ 85251-7630

Other practice location 1

7162 Liberty Centre Dr
Liberty Township, OH 45069-2562
Phone (513) 795-7557

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
I20211103001057 OH Practitioner - Nurse Practitioner 9931597432 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
Telehealth
Offers telehealth services
Group practices
Modern Psychiatry and Wellness LLCGroup PAC ID 6608029962, 23 clinicians

Practice addresses (Care Compare)

1910 Fairgrove Ave
Suite E
Hamilton, OH 45011-1930
Phone (513) 795-7557

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
434495OHMDRegistered Nurse
APRN.CNP.0029442OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Modern Psychiatry & Wellness, LLC CurrentSince Dec 2, 2024 Accepting new patients
Modern Psychiatry and Wellness LLC CurrentSince Dec 2, 2024 Accepting new patients

Locations

1910 Fairgrove Ave
Ste E
Hamilton, OH 45011
Phone (513) 299-4025

7162 Liberty Centre Dr
Liberty Township, OH 45069
Phone (513) 494-4679

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/5507/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.qualifacts.org/api/fhir/mpwhealth/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": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1174055529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 N SCOTTSDALE RD STE 2500",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852517630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5386 COX SMITH RD STE A",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450406803",
            "telephone_number": "216-468-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7162 Liberty Centre Dr",
            "address_purpose": "LOCATION",
            "city": "Liberty Township",
            "state": "OH",
            "postal_code": "450692562",
            "country_code": "US",
            "telephone_number": "513-795-7557",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUEVARA",
        "first_name": "JASON",
        "middle_name": "VINCENT",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-03",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "434495",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0029442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mason, OH

Sources for this page

Verify at the official NPI Registry.