Individual provider Active NPI

Marcia A. Stephens, NP

  • Gerontology Nurse Practitioner
  • Blue Ash, OH
National Provider Identifier
1699192955
Registry record updated Mar 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
COA.15753-NP Issued in OH
Practice address
10999 Reed Hartman Hwy Ste 215
Blue Ash, OH 45242-8301
Phone
(513) 745-9320
NPI assigned
Mar 25, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X COA.15753-NP OH Primary

Addresses

Primary practice location

10999 Reed Hartman Hwy Ste 215
Blue Ash, OH 45242-8301

Mailing address

10999 Reed Hartman Hwy Ste 215
Blue Ash, OH 45242-8301

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
I20140421000695 OH Practitioner - Nurse Practitioner 6305078650 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Cleanslate Medical Group of Ohio LLCGroup PAC ID 9537418025, 10 clinicians

Practice addresses (Care Compare)

1659 S Breiel Blvd
Middletown, OH 45044-6705
Phone (833) 505-4673

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
COA.15753-NPOHMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
HCR Manorcare Medical Services of Florida LLC CurrentSince Oct 26, 2015 Accepting new patients
Cleanslate Medical Group of Ohio LLC CurrentSince Aug 1, 2019 Accepting new patients
Midwest Hospitalists, Inc PastSince Aug 15, 2015 Accepting new patients

Locations

3654 Werk Rd
Cincinnati, OH 45248
Phone (513) 451-6001

L2540
Columbus, OH 43260

1659 S Breiel Blvd
Middletown, OH 45044
Phone (513) 424-0921

4700 Springboro Pike
Ste C
Moraine, OH 45439
Phone (937) 558-5100

247 S Burnett Rd
Ste 110
Springfield, OH 45505
Phone (937) 328-8921

1416 W 1st St
Springfield, OH 45504
Phone (614) 453-1589

333 N Summit St
Fl 7
Toledo, OH 43604
Phone (419) 252-5909

Organizations & group practices 3

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": "1395705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395792000000",
    "number": "1699192955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10999 REED HARTMAN HWY STE 215",
            "city": "BLUE ASH",
            "state": "OH",
            "postal_code": "452428301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10999 REED HARTMAN HWY STE 215",
            "city": "BLUE ASH",
            "state": "OH",
            "postal_code": "452428301",
            "telephone_number": "513-745-9320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "MARCIA",
        "middle_name": "A.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-25",
        "last_updated": "2014-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OH",
            "license": "COA.15753-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Ash, OH

Sources for this page

Verify at the official NPI Registry.