Individual provider Active NPI

Lina Nasr-Anaissie, M.D.

  • Family Medicine Physician
  • Liberty TWP, OH
National Provider Identifier
1386752947
Registry record updated Mar 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35-120321 Issued in OH
Practice address
6645 Princeton Glendale Rd
Liberty TWP, OH 45011-7547
Phone
(513) 829-2883
Fax
(513) 829-6346
NPI assigned
Aug 25, 2006
Last updated
Mar 27, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35-120321 OH Primary

Addresses

Primary practice location

6645 Princeton Glendale Rd
Liberty TWP, OH 45011-7547

Mailing address

PO Box 636256 Central Credentialing
Cincinnati, OH 45263-6256
Phone (513) 585-5507

Other identifiers 2

IdentifierTypeStateIssuer
7100242590MedicaidKY
0084667MedicaidOH

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130620000661 OH Practitioner - Family Practice 2264488584 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35-120321OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chenal Family Practice PastSince Jul 2, 2018 Accepting new patients
Jefferson Comprehensive Care System, Inc Past Accepting new patients
Arkansas Family Care Network Family Medicine Past Accepting new patients
Longinotti Williams Aprn Services PLLC PastSince Oct 1, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: lnasranaissie59300@direct.uchealth.com

Organizations & group practices 5

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": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553644800000",
    "number": "1386752947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636256 CENTRAL CREDENTIALING",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636256",
            "telephone_number": "513-585-5507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6645 PRINCETON GLENDALE RD",
            "city": "LIBERTY TWP",
            "state": "OH",
            "postal_code": "450117547",
            "telephone_number": "513-829-2883",
            "fax_number": "513-829-6346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASR-ANAISSIE",
        "first_name": "LINA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2019-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35-120321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100242590",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0084667",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty TWP, OH

Sources for this page

Verify at the official NPI Registry.