Alyssa Ann Vactor, APRN-CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0034380 Issued in OH

Practice address

1103 Fairington Dr
Sidney, OH 45365-8130

Phone

(937) 497-5561

NPI assigned

Jul 17, 2023

Last updated

Nov 12, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Alyssa Jones Former name

Electronic endpoints 2

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alliance Physicians IncGroup PAC ID 0840104360, 314 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kettering Health Troy Hospital, Troy, OH, CCN 360368
• Kettering Health Dayton Hospital, Dayton, OH, CCN 360133
• Wilson Memorial Hospital Hospital, Sidney, OH, CCN 360013

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Alliance Physicians Inc

  dba Kettering Health Medical Group

  • Family Medicine Physician
  • Kettering, OH
  • NPI 1437125572
  Medicare reassignment Care Compare group NPD
• Alliance Physicians Inc

  dba KMC OB on call

  • Obstetrics & Gynecology Physician
  • Kettering, OH
  • NPI 1992076178
  NPD
• Lima Memorial Joint Operating Company

  dba Lima Memorial Health System

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

• Dayton Osteopathic Hospital

  dba Kettering Health Dayton

  • General Acute Care Hospital
  • Dayton, OH
  • NPI 1053339507
  Care Compare affiliation
• Kettering Medical Center

  dba Kettering Health Troy

  • General Acute Care Hospital
  • Troy, OH
  • NPI 1023587045
  Care Compare affiliation
• Shelby County Memorial Hospital Association Inc.

  dba Wilson Health

  • General Acute Care Hospital
  • Sidney, OH
  • NPI 1639174204
  Care Compare affiliation

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

{
    "created_epoch": "1689552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1508545591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1535 GRIMES AVE",
            "city": "URBANA",
            "state": "OH",
            "postal_code": "430781013",
            "telephone_number": "937-507-1118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 FAIRINGTON DR",
            "city": "SIDNEY",
            "state": "OH",
            "postal_code": "453658130",
            "telephone_number": "937-497-5561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VACTOR",
        "first_name": "ALYSSA",
        "middle_name": "ANN",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-17",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "0034380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ajones665545@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "1103 Fairington Dr",
            "city": "Sidney",
            "state": "OH",
            "country_code": "US",
            "postal_code": "453658130",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "1103 Fairington Dr",
            "city": "Sidney",
            "state": "OH",
            "country_code": "US",
            "postal_code": "453658130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ALYSSA",
            "last_name": "JONES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Family Nurse Practitioner in Sidney, OH
• Providers in Sidney, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.