Individual provider Active NPI

Sakura Jessica Sip

  • Family Nurse Practitioner
  • Canal Winchester, OH
National Provider Identifier
1356057715
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.0032912 Issued in OH
Practice address
6095 Gender Rd
Canal Winchester, OH 43110-2014
Phone
(614) 417-5196
Fax
(614) 417-5197
NPI assigned
Jan 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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.0032912 OH Primary

Addresses

Primary practice location

6095 Gender Rd
Canal Winchester, OH 43110-2014

Mailing address

PO Box 932958
Cleveland, OH 44193-0028

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
I20230825000800 OH Practitioner - Nurse Practitioner 4587027420 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Little Clinic of Ohio LLCGroup PAC ID 7719087584, 212 clinicians

Practice addresses (Care Compare)

1621 N Memorial Dr
Lancaster, OH 43130-1632
Phone (740) 653-1354

Merit-based Incentive Payment System (MIPS)

Final score
86.78 of 100Reported as group
Quality
71.59
Promoting interoperability
100
Improvement activities
40
Cost
84.34

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0032912OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Little Clinic of Ohio LLC Family CurrentSince Aug 28, 2023 Accepting new patients

Locations

6095 Gender Rd
Canal Winchester, OH 43110
Phone (614) 417-5196

199 Graceland Blvd
Columbus, OH 43214
Phone (614) 410-2814

1621 N Memorial Dr
Lancaster, OH 43130
Phone (740) 653-1354

Interoperability endpoints

  • Direct secure messaging: sakura.sip@krogerhealth.eclinicaldirectplus.com

Organizations & group practices 1

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": "1674777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1356057715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 932958",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6095 GENDER RD",
            "city": "CANAL WINCHESTER",
            "state": "OH",
            "postal_code": "431102014",
            "telephone_number": "614-417-5196",
            "fax_number": "614-417-5197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIP",
        "first_name": "SAKURA",
        "middle_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-27",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0032912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canal Winchester, OH

Sources for this page

Verify at the official NPI Registry.