Individual provider Active NPI

Jonnie S Phillips, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Cincinnati, OH
National Provider Identifier
1649245960
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.08008 Issued in OH
Practice address
3747 W Fork Rd
Cincinnati, OH 45247-7548
Phone
(513) 961-4335
Fax
(513) 961-4227
NPI assigned
Feb 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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 08008 OH
Family Nurse Practitioner 363LF0000X APRN.CNP.08008 OH Primary

Addresses

Primary practice location

3747 W Fork Rd
Cincinnati, OH 45247-7548

Mailing address

3747 W Fork Rd
Cincinnati, OH 45247-7548
Phone (513) 961-4335

Other identifiers 6

IdentifierTypeStateIssuer
2535993MedicaidOH
7100056850MedicaidKY
78014164MedicaidKY
P00316324OtherRAIL ROAD MEDICARE
200517900MedicaidIN
200517900AMedicaidIN

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
I20041027000914 OH Practitioner - Nurse Practitioner 0941262430 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Physicians Cincinnati Specialty Care LLCGroup PAC ID 3971907759, 343 clinicians

Practice addresses (Care Compare)

3300 Mercy Health Blvd
Suite 2010
Cincinnati, OH 45211-1103
Phone (513) 421-3494

Hospital & facility affiliations

  • American Mercy Home Care, LLC Home health agency, Cincinnati, OH, CCN 367167
  • Mercy Health - West Hospital Hospital, Cincinnati, OH, CCN 360234

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
08008OHMDNurse Practitioner
APRN.CNP.08008OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Cincinnati LLC CurrentSince Mar 1, 2012 Accepting new patients
Mercy Health Physicians Cincinnati, LLC Nurse Practitioner CurrentSince Mar 1, 2012 Accepting new patients
Mercy Health Physicians Cincinnati Specialty Care LLC CurrentSince Sep 1, 2021 Accepting new patients
Mercy Health Physicians Cincinnati Specialty Care LLC Nurse Practitioner CurrentSince Sep 1, 2021 Accepting new patients

Locations

3747 W Fork Rd
Cincinnati, OH 45247
Phone (513) 481-4777

2446 Kipling Ave
Cincinnati, OH 45239
Phone (513) 583-8500

3300 Mercy Health Blvd
Ste 2010
Cincinnati, OH 45211
Phone (513) 686-5392

1701 Mercy Health Pl
Cincinnati, OH 45237
Phone (513) 952-5000

201 Old Bank Rd
Ste 103
Milford, OH 45150
Phone (513) 248-0100

Interoperability endpoints

  • Direct secure messaging: jphillips52239@direct.bsmhealth.org

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.

Hospital & facility affiliations 3

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": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1649245960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3747 W FORK RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452477548",
            "telephone_number": "513-961-4335",
            "fax_number": "513-961-4227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3747 W FORK RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452477548",
            "telephone_number": "513-961-4335",
            "fax_number": "513-961-4227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "JONNIE",
        "middle_name": "S",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-21",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "08008",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.08008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2535993",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100056850",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78014164",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P00316324",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200517900",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200517900A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.