Individual provider Active NPI

Tavissa Granger, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Cincinnati, OH
National Provider Identifier
1326870254
Registry record updated Jan 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN.CNP.0036206 Issued in OH
Practice address
4850 Smith Rd Ste 250
Cincinnati, OH 45212-2733
Phone
(513) 699-2053
NPI assigned
Aug 19, 2024
Last updated
Jan 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2026

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 APRN.CNP.0036206 OH Primary

Addresses

Primary practice location

4850 Smith Rd Ste 250
Cincinnati, OH 45212-2733

Mailing address

4850 Smith Rd Ste 250
Cincinnati, OH 45212-2733

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, KY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241015000850 OH Practitioner - Nurse Practitioner 3678005709 Reassigns benefits to 3 organizations
I20260602000479 KY Practitioner - Nurse Practitioner 3678005709 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Housecalls LLCGroup PAC ID 6709024268, 64 clinicians

Practice addresses (Care Compare)

7870 E Kemper Rd
Suite 150
Cincinnati, OH 45249-1675
Phone (513) 699-9090

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Supportive Healthcare Psych LLC Psychiatric/Mental Health CurrentSince Nov 17, 2025 Accepting new patients
Supportive Healthcare Skilled LLC CurrentSince Dec 8, 2025 Accepting new patients
Medical Housecalls LLC CurrentSince Oct 4, 2024 Accepting new patients

Locations

4001 Rosslyn Dr
Cincinnati, OH 45209
Phone (513) 272-0600

4850 Smith Rd
Cincinnati, OH 45212
Phone (513) 569-6750

7870 E Kemper Rd
Ste 150
Cincinnati, OH 45249
Phone (513) 258-2053

10111 Simonson Rd
Harrison, OH 45030
Phone (513) 367-7780

4850 Smith Rd
Ste 250
Norwood, OH 45212
Phone (513) 231-1060

4015 Executive Park Dr
Ste 406
Sharonville, OH 45241
Phone (513) 231-5753

Organizations & group practices 4

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": "1724025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768348800000",
    "number": "1326870254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4850 SMITH RD STE 250",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452122733",
            "fax_number": "513-752-0013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 SMITH RD STE 250",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452122733",
            "telephone_number": "513-699-2053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANGER",
        "first_name": "TAVISSA",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-19",
        "last_updated": "2026-01-14",
        "certification_date": "2026-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0036206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.