Active NPI
Felisha Tranna Jackson Ilyas, EDD-CI, LMSW, BS
- Social Worker
- Cincinnati, OH
National Provider Identifier
1487169595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- S1002121
- Practice address
- 3333 Burnet Avenue
Cincinnati, OH 45229 - Phone
- (513) 636-4200
- NPI assigned
- Dec 12, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | S1002121 | OH | Primary |
Addresses
Primary practice location
3333 Burnet Avenue
Cincinnati, OH 45229
Mailing address
3333 Burnet Avenue
Cincinnati, OH 45229
Phone (513) 636-4200
Other names 1
- Dr. Felisha Tranna Gibson(Married) Gross (Maiden)
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH, KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S1002121 | OH | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shifaa Serenity Therapy Solutions | Social Worker | Current | Accepting new patients |
| Mental Health Specialty Group PA | Current | Accepting new patients |
Locations
312 S 4th St
Ste 700
Louisville, KY 40202
Phone (502) 628-5023
800 N High St
Columbus, OH 43215
Phone (631) 540-8225
1251 Nilles Rd
Ste 8
Fairfield, OH 45014
Phone (513) 446-5048
Organizations & group practices 3
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.
-
- Social Worker
- Fairfield, OH
- NPI 1992696082
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671148800000",
"number": "1487169595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3333 BURNET AVENUE",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "45229",
"telephone_number": "513-636-4200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3333 BURNET AVENUE",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "45229",
"telephone_number": "513-636-4200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON ILYAS",
"first_name": "FELISHA",
"middle_name": "TRANNA",
"name_prefix": "Dr.",
"credential": "EDD-CI, LMSW, BS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-12-12",
"last_updated": "2022-12-16",
"certification_date": "2022-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "S1002121",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "FELISHA",
"last_name": "GIBSON(MARRIED) GROSS (MAIDEN)",
"middle_name": "TRANNA",
"prefix": "DR.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Cincinnati, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.