Individual provider Active NPI

Jill Stevenson

  • Registered Nurse
  • Dayton, OH
National Provider Identifier
1396566741
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN.407332 Issued in OH
Practice address
948 Patterson Rd
Dayton, OH 45419-4336
Phone
(937) 660-4145
NPI assigned
Oct 18, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN.CNP.0036512 OH
Registered Nurse 163W00000X RN.407332 OH Primary

Addresses

Primary practice location

948 Patterson Rd
Dayton, OH 45419-4336

Mailing address

948 Patterson Rd
Dayton, OH 45419-4336

Other practice location 1

4995 Bradenton Ave Ste 130
Dublin, OH 43017-3551
Phone (614) 580-6917

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
I20241210004011 OH Practitioner - Nurse Practitioner 5991231201 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Concord Psychiatry, LLCGroup PAC ID 3577884105, 37 clinicians

Practice addresses (Care Compare)

4995 Bradenton Ave
Suite 130
Dublin, OH 43017-3551
Phone (614) 580-6917

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Master of Arts

State licenses

LicenseStateTypeSpecialty
RN.407332OHMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Concord Psychiatry, LLC CurrentSince Feb 3, 2025 Accepting new patients
Oh Independent Medical Group LLC Past Accepting new patients

Locations

50 Old Village Rd
Ste 109
Columbus, OH 43228
Phone (614) 580-6917

4995 Bradenton Ave
Ste 130
Dublin, OH 43017
Phone (614) 580-6917

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": "1729209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1396566741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "948 PATTERSON RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454194336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "948 PATTERSON RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454194336",
            "telephone_number": "937-660-4145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4995 Bradenton Ave Ste 130",
            "address_purpose": "LOCATION",
            "city": "Dublin",
            "state": "OH",
            "postal_code": "430173551",
            "country_code": "US",
            "telephone_number": "614-580-6917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEVENSON",
        "first_name": "JILL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-18",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0036512",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.407332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.