Individual provider Active NPI

Laura Keel Sisson, AGACNP

  • Nurse Practitioner
  • Cincinnati, OH
National Provider Identifier
1588200877
Registry record updated Jul 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0029160 Issued in OH
Practice address
234 Goodman St
Cincinnati, OH 45219-2364
Phone
(513) 475-8282
NPI assigned
Nov 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1-175582 AL
Nurse Practitioner 363L00000X 0029160 OH Primary

Addresses

Primary practice location

234 Goodman St
Cincinnati, OH 45219-2364

Mailing address

2830 Victory Pkwy
Cincinnati, OH 45206-1785

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, OH, NC3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20200214002215 AL Practitioner - Nurse Practitioner 3274969050 Reassigns benefits to 1 organization
I20210826003735 OH Practitioner - Nurse Practitioner 3274969050 Reassigns benefits to 1 organization
I20240829003080 NC Practitioner - Nurse Practitioner 3274969050 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0029160OHMDNurse Practitioner
1-175582ALMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Alabama Health Services Foundation, PC. CurrentSince Dec 15, 2019 Accepting new patients
University of Cincinnati Physicians Company, LLC Nurse Practitioner CurrentSince Sep 13, 2021 Accepting new patients
Duke University Health System, Inc. CurrentSince Jul 1, 2024 Accepting new patients
Duke University Health System, Inc. Nurse Practitioner CurrentSince Jul 1, 2024 Accepting new patients

Locations

619 19th St S
Birmingham, AL 35249

619 19th St S
Birmingham, AL 35233
Phone (205) 934-6405

1802 6th Ave S
#5240
Birmingham, AL 35233
Phone (205) 934-4206

1802 6th Ave S
Birmingham, AL 35233
Phone (205) 934-5105

2301 Erwin Rd
Durham, NC 27705
Phone (919) 668-0289

2123 Auburn Ave
#A28
Cincinnati, OH 45219
Phone (513) 585-0523

3199 Highland Ave
Cincinnati, OH 45219
Phone (513) 475-7777

2830 Victory Pkwy
Cincinnati, OH 45206
Phone (513) 245-3335

3188 Bellevue Ave
Cincinnati, OH 45219
Phone (513) 558-5281

Interoperability endpoints

  • Direct secure messaging: lsisson585624@direct.medicine.duke.edu
  • Direct secure messaging: lsisson392556@direct.uchealth.com

Organizations & group practices 4

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": "1574294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1588200877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2830 VICTORY PKWY",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452061785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 GOODMAN ST",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452192364",
            "telephone_number": "513-475-8282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISSON",
        "first_name": "LAURA",
        "middle_name": "KEEL",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-21",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AL",
            "license": "1-175582",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "0029160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.