Individual provider Active NPI

Amanda M Bohannon, FNP-BC

  • Family Nurse Practitioner
  • Sharonville, OH
National Provider Identifier
1356723902
Registry record updated Sep 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
COA.17292-NP Issued in OH
Practice address
12110 Lebanon Rd
Sharonville, OH 45241-1739
Phone
(513) 853-9700
NPI assigned
Jun 19, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2021

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 COA.17292-NP OH Primary

Addresses

Primary practice location

12110 Lebanon Rd
Sharonville, OH 45241-1739

Mailing address

12110 Lebanon Rd
Sharonville, OH 45241-1739

Other identifiers 1

IdentifierTypeStateIssuer
0135028MedicaidOH

Other names 1

  • Ms. Amanda Casada Former name

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
I20150713002146 OH Practitioner - Nurse Practitioner 3375856891 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trihealth G LLCGroup PAC ID 0749222651, 294 clinicians

Practice addresses (Care Compare)

2001 Anderson Ferry Rd
Cincinnati, OH 45238-3325
Phone (513) 246-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17292OHMDDentist
COA.17292-NPOHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CG Medical Associates Inc CurrentSince Jun 22, 2015 Accepting new patients
Trihealth H LLC CurrentSince Nov 24, 2022 Accepting new patients
Trihealth U LLC CurrentSince Feb 1, 2020 Accepting new patients
Trihealth G, LLC CurrentSince Jan 15, 2020 Accepting new patients
Trihealth G LLC CurrentSince Jan 15, 2020 Accepting new patients
Trihealth G LLC Past Accepting new patients

Locations

2001 Anderson Ferry Rd
Cincinnati, OH 45238
Phone (513) 922-1200

7300 Beechmont Ave
Cincinnati, OH 45230
Phone (513) 232-9100

9070 Winton Rd
Cincinnati, OH 45231
Phone (513) 246-2750

375 Dixmyth Ave
Cincinnati, OH 45220
Phone (513) 862-2432

9775 Colerain Ave
Cincinnati, OH 45251
Phone (513) 385-6900

6331 Glenway Ave
Cincinnati, OH 45211
Phone (513) 389-1400

375 Dixmyth Ave
Ste 3135
Cincinnati, OH 45220
Phone (513) 862-3452

6350 Glenway Ave
Ste 300
Cincinnati, OH 45211
Phone (513) 481-9700

12110 Lebanon Rd
Sharonville, OH 45241
Phone (513) 853-9700

Interoperability endpoints

  • Direct secure messaging: abohannon245095@direct.trihealth.com

Organizations & group practices 7

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1434672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632096000000",
    "number": "1356723902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12110 LEBANON RD",
            "city": "SHARONVILLE",
            "state": "OH",
            "postal_code": "452411739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12110 LEBANON RD",
            "city": "SHARONVILLE",
            "state": "OH",
            "postal_code": "452411739",
            "telephone_number": "513-853-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHANNON",
        "first_name": "AMANDA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-19",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA.17292-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0135028",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "CASADA",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sharonville, OH

Sources for this page

Verify at the official NPI Registry.