Individual provider Active NPI

Mary Cathleen O'Shea

  • Family Nurse Practitioner
  • Cincinnati, OH
National Provider Identifier
1639511520
Registry record updated Oct 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
COA14677 Issued in OH
Practice address
8040 Princeton-Glendale Rd
Cincinnati, OH 45069-0000
Phone
(513) 246-7000
Fax
(513) 246-5479
NPI assigned
Jul 22, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2014

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 COA14677 OH Primary

Addresses

Primary practice location

8040 Princeton-Glendale Rd
Cincinnati, OH 45069-0000

Mailing address

4685 Forest Ave Ste C
Cincinnati, OH 45212-3359
Phone (513) 246-7796

Other identifiers 2

IdentifierTypeStateIssuer
87943MedicaidOH
COA.14677OtherOHOHIO LICENSE

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
I20130814000963 OH Practitioner - Nurse Practitioner 0345482741 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
COA14677OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Trihealth G, LLC CurrentSince Jul 21, 2014 Accepting new patients
Trihealth G LLC CurrentSince Jul 21, 2014 Accepting new patients

Locations

4685 Forest Ave
Cincinnati, OH 45212
Phone (513) 853-4721

2001 Anderson Ferry Rd
Cincinnati, OH 45238
Phone (513) 922-1200

9070 Winton Rd
Cincinnati, OH 45231
Phone (513) 246-2750

4685 Forest Ave
Ste C
Norwood, OH 45212
Phone (513) 246-7796

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.

NPI Registry JSON

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

{
    "created_epoch": "1374451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412208000000",
    "number": "1639511520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4685 FOREST AVE STE C",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452123359",
            "telephone_number": "513-246-7796",
            "fax_number": "513-852-8525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8040 PRINCETON-GLENDALE RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "450690000",
            "telephone_number": "513-246-7000",
            "fax_number": "513-246-5479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'SHEA",
        "first_name": "MARY",
        "middle_name": "CATHLEEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-22",
        "last_updated": "2014-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA14677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "87943",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO LICENSE",
            "identifier": "COA.14677",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.