Individual provider Active NPI

Victoria Marie Dennis, FNP

  • Family Nurse Practitioner
  • Warren, OH
National Provider Identifier
1295331429
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.0027798 Issued in OH
Practice address
735 Niles Cortland Rd SE Ste 2
Warren, OH 44484-2475
Phone
(330) 856-6365
NPI assigned
Dec 11, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.0027798 OH Primary

Addresses

Primary practice location

735 Niles Cortland Rd SE Ste 2
Warren, OH 44484-2475

Mailing address

2337 Hunters RDG
Boardman, OH 44512-8110
Phone (330) 651-0053

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
I20210121001161 OH Practitioner - Nurse Practitioner 3375957046 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Warren Dermatology and Mohs Surgery LLCGroup PAC ID 8628384070, 5 clinicians

Practice addresses (Care Compare)

1745 Niles Corland Rd NE
Suite 5
Warren, OH 44484
Phone (330) 856-6365

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0027798OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Warren Dermatology and Mohs Surgery LLC. CurrentSince Apr 14, 2022 Accepting new patients
Ohio Medical Specialists, LLC Past Accepting new patients

Locations

1745 Niles Cortland Rd NE
Ste 5
Warren, OH 44484
Phone (330) 856-6365

735 Niles Cortland Rd SE
Ste 2
Warren, OH 44484
Phone (330) 856-6365

735 Niles Cortland Rd SE
Ste 201
Warren, OH 44484

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": "1607644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1295331429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2337 HUNTERS RDG",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445128110",
            "telephone_number": "330-651-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 NILES CORTLAND RD SE STE 2",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444842475",
            "telephone_number": "330-856-6365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNIS",
        "first_name": "VICTORIA",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-11",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0027798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, OH

Sources for this page

Verify at the official NPI Registry.