Active NPI
Tina Marie Gutekunst
- Nurse Practitioner
- Ft Mitchell, KY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 3010634
- Practice address
- 2300 Chamber Center Drive
Ft. Mitchell, KY 41017 - Phone
- (859) 341-3114
- Fax
- (859) 578-2156
- NPI assigned
- Jun 7, 2016
- Last updated
- Jan 11, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 71009290A | IN | |
| Nurse Practitioner | 363L00000X | 3010634 | KY | Primary |
| Family Nurse Practitioner | 363LF0000X | COA.18966-NP | OH |
Addresses
Primary practice location
2300 Chamber Center Drive
Ft. Mitchell, KY 41017
Mailing address
PO Box 635283
Cincinnati, OH 45263-5283
Phone (859) 341-3114
Other names 1
- Tina Marie Bailey
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH, KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- University of Cincinnati College of Medicine, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
2300 Chamber Ctr Dr
Suite 100
Lakeside Park, KY 41017-1686
Phone (859) 341-3114
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71009290A | IN | MD | Nurse Practitioner |
| 3010634 | KY | MD | Nurse Practitioner |
| COA.18966-NP | OH | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summit Medical Group, Inc. | Current | Accepting new patients | |
| Pain Specialists of Cincinnati, LLC | Current | Accepting new patients | |
| Summit Medical Group, Inc | Nurse Practitioner | Current | Accepting new patients |
Locations
230 6th St
Rising Sun, IN 47040
Phone (812) 438-2555
1980 Litton Ln
Hebron, KY 41048
Phone (859) 334-8700
2300 Chamber Center Dr
Ste 100
Lakeside Park, KY 41017
Phone (859) 331-2440
300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217
3328 Westbourne Dr
Cincinnati, OH 45248
Phone (513) 922-1599
Interoperability endpoints
- tgutekunst297349@direct-prd.stelizabeth.com
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.
-
dba St. Elizabeth Physicians
- Family Medicine Physician
- Erlanger, KY
- NPI 1750343216
Nurse Practitioner
-
- Pain Medicine (Physical Medicine & Rehabilitation) Physician
- Cincinnati, OH
- NPI 1558740282
-
dba St. Elizabeth Physicians
- Foot & Ankle Surgery Podiatrist
- Crestview Hills, KY
- NPI 1043188378
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba St Elizabeth Florence
- General Acute Care Hospital
- Florence, KY
- NPI 1154365062
-
- General Acute Care Hospital
- Edgewood, KY
- NPI 1467492421
-
dba St Elizabeth Ft. Thomas
- General Acute Care Hospital
- Fort Thomas, KY
- NPI 1740221795
-
dba St. Elizabeth Home Care
- Home Health Agency
- Florence, KY
- NPI 1316136534
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673395200000",
"number": "1295184679",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 635283",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452635283",
"telephone_number": "859-341-3114",
"fax_number": "859-578-2156"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2300 CHAMBER CENTER DRIVE",
"city": "FT. MITCHELL",
"state": "KY",
"postal_code": "41017",
"telephone_number": "859-341-3114",
"fax_number": "859-578-2156"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUTEKUNST",
"first_name": "TINA",
"middle_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-07",
"last_updated": "2023-01-11",
"certification_date": "2023-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IN",
"license": "71009290A",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "KY",
"license": "3010634",
"primary": true
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OH",
"license": "COA.18966-NP",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "TINA",
"last_name": "BAILEY",
"middle_name": "MARIE",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Ft Mitchell, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.