Individual provider Active NPI

Michelle Hennessy

  • Nurse Practitioner
  • Sharonville, OH
National Provider Identifier
1710579206
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0028525 Issued in OH
Practice address
12110 Lebanon Rd
Sharonville, OH 45241-1739
Phone
(513) 853-9700
NPI assigned
Feb 6, 2021
Last updated
Jul 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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 0028525 OH Primary
Registered Nurse 163W00000X RN.403085 OH

Addresses

Primary practice location

12110 Lebanon Rd
Sharonville, OH 45241-1739

Mailing address

12110 Lebanon Rd
Sharonville, OH 45241-1739
Phone (513) 853-9700

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
I20210311000700 OH Practitioner - Nurse Practitioner 8426464702 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Group practices
Trihealth U LLCGroup PAC ID 5799110953, 31 clinicians

Practice addresses (Care Compare)

719 Ohio Pike
Cincinnati, OH 45245-2131
Phone (513) 853-9700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN.403085OHMDRegistered Nurse
0028525OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Trihealth U LLC CurrentSince Oct 25, 2021 Accepting new patients
CG Medical Associates Inc CurrentSince Mar 10, 2021 Accepting new patients

Locations

5403 N Bend Rd
Cincinnati, OH 45247
Phone (513) 662-1459

719 Ohio Pike
Cincinnati, OH 45245
Phone (513) 753-7578

7300 Beechmont Ave
Cincinnati, OH 45230
Phone (513) 232-9100

9775 Colerain Ave
Cincinnati, OH 45251
Phone (513) 385-6900

4090 E Galbraith Rd
Deer Park, OH 45236
Phone (513) 853-9700

10541 Harrison Ave
Harrison, OH 45030
Phone (513) 367-2103

10529 Loveland Madeira Rd
Loveland, OH 45140
Phone (513) 683-5615

4605 Montgomery Rd
Norwood, OH 45212
Phone (513) 731-0062

12110 Lebanon Rd
Sharonville, OH 45241
Phone (513) 853-9700

Interoperability endpoints

  • Direct secure messaging: mhennessy349130@direct.trihealth.com

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 1

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": "1612569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1710579206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12110 LEBANON RD",
            "city": "SHARONVILLE",
            "state": "OH",
            "postal_code": "452411739",
            "telephone_number": "513-853-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12110 LEBANON RD",
            "city": "SHARONVILLE",
            "state": "OH",
            "postal_code": "452411739",
            "telephone_number": "513-853-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNESSY",
        "first_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-06",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "0028525",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.403085",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sharonville, OH

Sources for this page

Verify at the official NPI Registry.