Individual provider Active NPI

Tonya Denette Edmondson, NURSE PRACTITIONER

  • Psychiatric/Mental Health Nurse Practitioner
  • Cincinnati, OH
National Provider Identifier
1588808364
Registry record updated Jan 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN.345779 Issued in OH
Practice address
10296 Springfield Pike Ste 500
Cincinnati, OH 45215-1194
Phone
(513) 942-4555
NPI assigned
Apr 24, 2009
Last updated
Jan 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X COA. 19101-NP OH
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN.345779 OH Primary

Addresses

Primary practice location

10296 Springfield Pike Ste 500
Cincinnati, OH 45215-1194

Mailing address

10296 Springfield Pike Ste 500
Cincinnati, OH 45215-1194
Phone (513) 942-4555

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
I20160829002835 OH Practitioner - Nurse Practitioner 1254626260 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Maumee Valley Guidance Center IncGroup PAC ID 0547293003, 7 clinicians

Practice addresses (Care Compare)

2420 Harrison Ave
Suite 12
Cincinnati, OH 45211-7926
Phone (513) 406-3626

910 E Maple St
Bryan, OH 43506-1841
Phone (419) 636-2932

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
COA. 19101-NPOHMDFamily Nurse Practitioner
RN.345779OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Maumee Valley Guidance Center Inc. CurrentSince May 14, 2018 Accepting new patients
Ohioguidestone CurrentSince Aug 13, 2019 Accepting new patients
Ohioguidestone CurrentSince Aug 13, 2019 Accepting new patients
Ohioguidestone Current Accepting new patients
Path of Goodness Psychiatric/Mental Health CurrentSince Jan 17, 2024 Accepting new patients
Viaquest Home Health LLC Past Accepting new patients

Locations

202 E Bagley Rd
Berea, OH 44017
Phone (800) 234-2006

910 E Maple St
Bryan, OH 43506
Phone (419) 636-2932

2420 Harrison Ave
Ste 12
Cincinnati, OH 45211
Phone (513) 406-3626

211 Biede Ave
Defiance, OH 43512
Phone (419) 782-8856

2173 N Ridge Rd E
Ste E
Lorain, OH 44055
Phone (440) 260-6100

1325 Woodlawn Ave
Napoleon, OH 43545
Phone (410) 592-1500

Organizations & group practices 7

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.

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": "1240531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1588808364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10296 SPRINGFIELD PIKE STE 500",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452151194",
            "telephone_number": "513-942-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10296 SPRINGFIELD PIKE STE 500",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452151194",
            "telephone_number": "513-942-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMONDSON",
        "first_name": "TONYA",
        "middle_name": "DENETTE",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-24",
        "last_updated": "2024-01-26",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA. 19101-NP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "RN.345779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.