Individual provider Active NPI

Tracy Lynette Richardson, NURSE PRACTITIONER

  • Gerontology Nurse Practitioner
  • Cincinnati, OH
National Provider Identifier
1649994245
Registry record updated Jun 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
0032089 Issued in OH
Practice address
5050 Glencrossing Way
Cincinnati, OH 45238-3360
Phone
(513) 813-4311
NPI assigned
Sep 28, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 0032089 OH Primary
Adult Health Nurse Practitioner 363LA2200X 0032089 OH

Addresses

Primary practice location

5050 Glencrossing Way
Cincinnati, OH 45238-3360

Mailing address

3183 Sunnyhollow LN
Cincinnati, OH 45239-7152
Phone (513) 462-0222

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
I20230113001079 OH Practitioner - Nurse Practitioner 9638540453 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0032089OHMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
PA Post Acute Services PC CurrentSince Jan 21, 2024 Accepting new patients
Dedicated Ohio Holding, LLC CurrentSince Jun 1, 2026 Accepting new patients
Dedicated Ohio Holding LLC CurrentSince Jun 1, 2026 Accepting new patients

Locations

625 Probasco St
Cincinnati, OH 45220
Phone (513) 281-0745

5050 Glencrossing Way
Cincinnati, OH 45238
Phone (513) 813-4311

8055 Addison Rd
Masury, OH 44438
Phone (330) 448-2547

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1664323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780876800000",
    "number": "1649994245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3183 SUNNYHOLLOW LN",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452397152",
            "telephone_number": "513-462-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 GLENCROSSING WAY",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452383360",
            "telephone_number": "513-813-4311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "TRACY",
        "middle_name": "LYNETTE",
        "name_prefix": "Ms.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-28",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OH",
            "license": "0032089",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "0032089",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.