Individual provider Active NPI

Dominic Lattarulo, MSN, APRN, PMHNP-C

  • Psychiatric/Mental Health Nurse Practitioner
  • Cincinnati, OH
National Provider Identifier
1679225155
Registry record updated Nov 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN.CNP.0040185 Issued in OH
Practice address
830 Ezzard Charles Dr
Cincinnati, OH 45214-2525
Phone
(513) 381-6672
NPI assigned
Jan 25, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN.CNP.0040185 OH Primary
Registered Nurse 163W00000X RN.424439 OH

Addresses

Primary practice location

830 Ezzard Charles Dr
Cincinnati, OH 45214-2525

Mailing address

6167 Woodville Dr
Loveland, OH 45140-7555
Phone (513) 550-4555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
RN.424439OHMDRegistered Nurse
APRN.CNP.0040185OHMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1643068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762473600000",
    "number": "1679225155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6167 WOODVILLE DR",
            "city": "LOVELAND",
            "state": "OH",
            "postal_code": "451407555",
            "telephone_number": "513-550-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 EZZARD CHARLES DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452142525",
            "telephone_number": "513-381-6672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATTARULO",
        "first_name": "DOMINIC",
        "credential": "MSN, APRN, PMHNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-01-25",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0040185",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.424439",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.