Individual provider Active NPI

Debra Ann Koenke, NP

  • Acute Care Nurse Practitioner
  • Cincinnati, OH
National Provider Identifier
1588085054
Registry record updated Dec 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
COA.15350 Issued in OH
Practice address
2123 Auburn Ave
Cincinnati, OH 45219-2906
Phone
(513) 585-2791
Fax
(513) 421-2601
NPI assigned
Dec 30, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X COA.15350 OH
Acute Care Nurse Practitioner 363LA2100X COA.15350 OH Primary

Addresses

Primary practice location

2123 Auburn Ave
Cincinnati, OH 45219-2906

Mailing address

237 William Howard Taft Rd
2ND Floor, Cbo2-3, Attn: Credentialing
Cincinnati, OH 45219-2610
Phone (513) 263-8551

Other names 1

  • Debra Ann Leesman Former name

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
I20140115001729 OH Practitioner - Nurse Practitioner 2264660471 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Christ Hospital Medical Associates, LLCGroup PAC ID 0244314102, 270 clinicians

Practice addresses (Care Compare)

2123 Auburn Ave
Suite 204
Cincinnati, OH 45219-2906
Phone (513) 585-2791

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.71 of 100Reported as group
Quality
83.07
Promoting interoperability
100
Improvement activities
40
Cost
79.29

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
COA.15350OHMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Christ Hospital Medical Associates, LLC Nurse Practitioner CurrentSince Dec 1, 2013 Accepting new patients

Locations

2123 Auburn Ave
Ste 204
Cincinnati, OH 45219
Phone (513) 421-8181

2123 Auburn Ave
#200
Cincinnati, OH 45219
Phone (513) 321-0833

2123 Auburn Ave
Cincinnati, OH 45219
Phone (513) 721-7373

237 Wm Howard Taft Rd
Cincinnati, OH 45219
Phone (513) 351-9900

2123 Auburn Ave
Ste A44
Cincinnati, OH 45219
Phone (513) 585-2791

Organizations & group practices 1

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 1

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": "1388361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388361600000",
    "number": "1588085054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 WILLIAM HOWARD TAFT RD",
            "address_2": "2ND FLOOR, CBO2-3, ATTN: CREDENTIALING",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452192610",
            "telephone_number": "513-263-8551",
            "fax_number": "513-366-4480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2123 AUBURN AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452192906",
            "telephone_number": "513-585-2791",
            "fax_number": "513-421-2601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOENKE",
        "first_name": "DEBRA",
        "middle_name": "ANN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-30",
        "last_updated": "2013-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "COA.15350",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "COA.15350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBRA",
            "last_name": "LEESMAN",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.