Active NPI
Dynamic Telehealth LLC
- Psychiatric/Mental Health Nurse Practitioner
- Fairfield, OH
National Provider Identifier
1174305965
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- Legal business name
- DYNAMIC TELEHEALTH LLC
- Practice address
- 31 Stonegate CT
Fairfield, OH 45014 - Phone
- (513) 302-2820
- NPI assigned
- Oct 17, 2023
- Last updated
- Jan 9, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Cheryl Anntoinette Wilkerson, CNP
- Title
- President
- Phone
- (513) 302-2820
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Service Clinic/Center | 261QH0100X | NU | ||
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | NU | Primary |
Addresses
Primary practice location
31 Stonegate CT
Fairfield, OH 45014
Mailing address
31 Stonegate CT
Fairfield, OH 45014
Phone (513) 302-2820
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
9909 Springfield Pike
Cincinnati, OH 45215
Phone (513) 596-9822
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Nurse Practitioner
- Hamilton, OH
- NPI 1801157490
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1697500800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1767916800000",
"number": "1174305965",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31 STONEGATE CT",
"city": "FAIRFIELD",
"state": "OH",
"postal_code": "45014",
"telephone_number": "513-302-2820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "31 STONEGATE CT",
"city": "FAIRFIELD",
"state": "OH",
"postal_code": "45014",
"telephone_number": "513-302-2820"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DYNAMIC TELEHEALTH LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-10-17",
"last_updated": "2026-01-09",
"certification_date": "2026-01-09",
"status": "A",
"authorized_official_last_name": "WILKERSON",
"authorized_official_first_name": "CHERYL",
"authorized_official_middle_name": "ANNTOINETTE",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "513-302-2820",
"authorized_official_credential": "CNP"
},
"taxonomies": [
{
"code": "261QH0100X",
"taxonomy_group": "",
"desc": "Clinic/Center, Health Service",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fairfield, OH
- Dva Healthcare Southwest Ohio LLC (Fairfield Dialysis)
- Dva Renal Healthcare Inc (Fairfield Home Training Dialysis)
- Lamonda D Dye, LPN
- Dymphna Mental Health Services LLC
- Dynamic Care Assistance, LLC
- Charles William Eastlick, LICDC, LPC, M.ED.
- Nicholas Anthony Eberly
- Daniel Clark Eckert, MD
- Allison Leigh Edgington
- Clarissa Edwards
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.