Individual provider Active NPI

Mary T Sharpshair, FNP-BC, NP-C

  • Family Nurse Practitioner
  • Lebanon, OH
National Provider Identifier
1558863860
Registry record updated Mar 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.022458 Issued in OH
Practice address
1000 Columbus Ave Ste B
Lebanon, OH 45036-8330
Phone
(513) 934-7171
NPI assigned
Mar 2, 2018
Last updated
Mar 8, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.022458 OH Primary

Addresses

Primary practice location

1000 Columbus Ave Ste B
Lebanon, OH 45036-8330

Mailing address

10651 Bridlepath LN
Cincinnati, OH 45241-2911
Phone (513) 882-6735

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, KY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180323000513 OH Practitioner - Nurse Practitioner 4284996687 Reassigns benefits to 2 organizations
I20210303001040 KY Practitioner - Nurse Practitioner 4284996687 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CG Medical Associates IncGroup PAC ID 6608052196, 171 clinicians

Practice addresses (Care Compare)

1000 Columbus Ave
Suite B
Lebanon, OH 45036-8330
Phone (513) 934-7171

3457 Valleyplaza Pkwy
Ft Wright, KY 41017-8176
Phone (513) 846-6778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN.CNP.022458OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Clinic 21 of Nevada Zyniewicz PLLC CurrentSince Apr 1, 2021 Accepting new patients
The Dermatology Group, Inc CurrentSince Sep 7, 2021 Accepting new patients
CG Medical Associates Inc CurrentSince Mar 14, 2018 Accepting new patients

Locations

650 Sprucewood Ln
Erlanger, KY 41018
Phone (859) 282-6600

7683 Mall Rd
Unit B
Florence, KY 41042
Phone (859) 817-1320

3457 Valleyplaza Pkwy
Ft Wright, KY 41017
Phone (513) 846-6778

5216 Boulder Hwy
Ste 105
Las Vegas, NV 89122
Phone (513) 846-6778

7300 Beechmont Ave
Cincinnati, OH 45230
Phone (513) 232-9100

1000 Columbus Ave
Unit B
Lebanon, OH 45036
Phone (513) 934-7171

5298 Socialville Foster Rd
Mason, OH 45040

4406 Montgomery Rd
Norwood, OH 45212
Phone (513) 376-7116

36 Remick Blvd
Springboro, OH 45066

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/5662/brand/1/csg/1/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1519948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520467200000",
    "number": "1558863860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10651 BRIDLEPATH LN",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452412911",
            "telephone_number": "513-882-6735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 COLUMBUS AVE STE B",
            "city": "LEBANON",
            "state": "OH",
            "postal_code": "450368330",
            "telephone_number": "513-934-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARPSHAIR",
        "first_name": "MARY",
        "middle_name": "T",
        "credential": "FNP-BC, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-02",
        "last_updated": "2018-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.022458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, OH

Sources for this page

Verify at the official NPI Registry.