NPIMap

Individual provider Active NPI

Michelle M Menard, PA-C

  • Medical Physician Assistant
  • Loveland, OH
National Provider Identifier
1558782847
Registry record updated Sep 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
50.004857RX Issued in OH
Practice address
6535 Snider Rd
Loveland, OH 45140-9588
Phone
(513) 575-1444
Fax
(513) 575-1451
NPI assigned
Jan 3, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0110004801 VA
Medical Physician Assistant 363AM0700X PA.0003641 CO
Medical Physician Assistant 363AM0700X 50.004857RX OH Primary

Addresses

Primary practice location

6535 Snider Rd
Loveland, OH 45140-9588

Mailing address

424 Wards Corner Rd Ste 200
Loveland, OH 45140-6966
Phone (513) 707-4041

Other identifiers 1

IdentifierTypeStateIssuer
0217632MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA.0003641COMDMedical Physician Assistant
50.004857RXOHMDMedical Physician Assistant
0110004801VAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Healthsource of Ohio, Inc. Current Accepting new patients
Healthsource of Ohio, Inc. Current Accepting new patients
Healthsource of Ohio, Inc. CurrentSince May 1, 2017 Accepting new patients
Healthsource of Ohio Inc Current Accepting new patients
Healthsource of Ohio Inc Current Accepting new patients
Healthsource of Ohio, Inc. Current Accepting new patients
Healthsource of Ohio, Inc. Current Accepting new patients
Healthsource of Ohio Inc Current Accepting new patients
Healthsource of Ohio, Inc. Current Accepting new patients
Healthsource of Ohio, Inc. Current Accepting new patients
Healthsource of Ohio, Inc. CurrentSince May 1, 2017 Accepting new patients
Healthsource of Ohio, Inc. Current Accepting new patients

Locations

6535 Charles Snider Rd
Goshen, OH 45140
Phone (513) 575-1444

424 Wards Corner Rd
Ste 200
Loveland, OH 45140
Phone (513) 707-4041

Organizations & group practices 12

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": "1388707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599696000000",
    "number": "1558782847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 WARDS CORNER RD STE 200",
            "city": "LOVELAND",
            "state": "OH",
            "postal_code": "451406966",
            "telephone_number": "513-707-4041",
            "fax_number": "513-576-1020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6535 SNIDER RD",
            "city": "LOVELAND",
            "state": "OH",
            "postal_code": "451409588",
            "telephone_number": "513-575-1444",
            "fax_number": "513-575-1451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENARD",
        "first_name": "MICHELLE",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-03",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110004801",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "PA.0003641",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50.004857RX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0217632",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Loveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.