Individual provider Active NPI

Desiree Vance

  • Family Nurse Practitioner
  • Englewood, OH
National Provider Identifier
1679022933
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.019953 Issued in OH
Practice address
9000 N Main St Ste 300
Englewood, OH 45415-1165
Phone
(937) 832-1500
Fax
(937) 832-0662
NPI assigned
Sep 28, 2016
Last updated
May 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2026

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 APRN.CNP.019953 OH Primary

Addresses

Primary practice location

9000 N Main St Ste 300
Englewood, OH 45415-1165

Mailing address

9000 N Main St Ste 300
Englewood, OH 45415-1165
Phone (937) 832-1500

Other identifiers 1

IdentifierTypeStateIssuer
0189735MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
RESTful URL dvance17451@direct.premierhealth.com

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
I20161121002410 OH Practitioner - Nurse Practitioner 5395024095 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Samaritan Family Care IncGroup PAC ID 5092608372, 58 clinicians

Practice addresses (Care Compare)

9000 N Main St
Suite 300
Englewood, OH 45415-1165
Phone (937) 832-1500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CNP.019953OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Family Care Inc CurrentSince Apr 12, 2021 Accepting new patients
Samaritan Family Care, Inc. Past Accepting new patients

Locations

1530 Needmore Rd
Ste 200
Dayton, OH 45414
Phone (937) 278-5854

9000 N Main St
Ste 300
Englewood, OH 45415
Phone (937) 297-6800

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

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": "1475020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1679022933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 N MAIN ST STE 300",
            "city": "ENGLEWOOD",
            "state": "OH",
            "postal_code": "454151165",
            "telephone_number": "937-832-1500",
            "fax_number": "937-832-0662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 N MAIN ST STE 300",
            "city": "ENGLEWOOD",
            "state": "OH",
            "postal_code": "454151165",
            "telephone_number": "937-832-1500",
            "fax_number": "937-832-0662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANCE",
        "first_name": "DESIREE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-28",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.019953",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0189735",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "REST",
            "endpointTypeDescription": "RESTful URL",
            "endpoint": "dvance17451@direct.premierhealth.com",
            "affiliation": "N",
            "address_1": "9000 N Main St Ste 300",
            "city": "Englewood",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454151165",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Englewood, OH

Sources for this page

Verify at the official NPI Registry.