Individual provider Active NPI

Bonnie Anne Loesch, CNP

  • Family Nurse Practitioner
  • Centerville, OH
National Provider Identifier
1558829671
Registry record updated Jan 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.024764 Issued in OH
Practice address
2350 Miami Valley Dr Ste 500
Centerville, OH 45459-4780
Phone
(937) 293-1622
Fax
(937) 245-6308
NPI assigned
Mar 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.402108 OH
Nurse Practitioner 363L00000X 024764 OH
Family Nurse Practitioner 363LF0000X APRN.CNP.024764 OH Primary

Addresses

Primary practice location

2350 Miami Valley Dr Ste 500
Centerville, OH 45459-4780

Mailing address

6680 Poe Ave Ste 200
Dayton, OH 45414-2855
Phone (937) 280-8400

Other practice location 1

9000 N Main St Ste 200
Englewood, OH 45415-1165
Phone (937) 293-1622

Other identifiers 1

IdentifierTypeStateIssuer
0365931MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bloesch1476445@direct.premierhealth.com

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
I20190822001313 OH Practitioner - Nurse Practitioner 8022346576 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dayton Physicians LLCGroup PAC ID 1456374859, 40 clinicians

Practice addresses (Care Compare)

2350 Miami Valley Dr
Suite 500
Centerville, OH 45459-4780
Phone (937) 293-1622

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.58 of 100Reported as individual
Quality
87.11
Promoting interoperability
100
Improvement activities
40
Cost
88.14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN.402108OHMDRegistered Nurse
APRN.CNP.024764OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dayton Physicians, LLC CurrentSince Jun 26, 2019 Accepting new patients
Dayton Physicians, LLC CurrentSince Jun 26, 2019 Accepting new patients

Locations

1 Wyoming St
Dayton, OH 45409
Phone (937) 208-2636

6680 Poe Ave
Ste 200
Dayton, OH 45414

2350 Miami Valley Dr
Ste 500
Dayton, OH 45459
Phone (937) 425-0003

9000 N Main St
Ste G-36
Englewood, OH 45415
Phone (937) 832-1093

9000 N Main St
Ste 200
Englewood, OH 45415
Phone (937) 495-0000

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1551916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641513600000",
    "number": "1558829671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6680 POE AVE STE 200",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454142855",
            "telephone_number": "937-280-8400",
            "fax_number": "937-280-8373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 MIAMI VALLEY DR STE 500",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454594780",
            "telephone_number": "937-293-1622",
            "fax_number": "937-245-6308"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9000 N Main St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Englewood",
            "state": "OH",
            "postal_code": "454151165",
            "country_code": "US",
            "telephone_number": "937-293-1622",
            "fax_number": "937-245-6308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOESCH",
        "first_name": "BONNIE",
        "middle_name": "ANNE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-07",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.402108",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "024764",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.024764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0365931",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bloesch1476445@direct.premierhealth.com",
            "affiliation": "N",
            "address_1": "2350 Miami Valley Dr Ste 500",
            "city": "Centerville",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454594780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Centerville, OH

Sources for this page

Verify at the official NPI Registry.