Gwendolyn L Detillion, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F03250051 Issued in OH

Practice address

4850 Smith Rd Ste 250
Cincinnati, OH 45212-2733

Phone

(704) 776-5577

NPI assigned

Mar 7, 2025

Last updated

Apr 10, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medical Housecalls LLCGroup PAC ID 6709024268, 64 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Medical Housecalls LLC

  dba Supportive Healthcare

  • Family Nurse Practitioner
  • Cincinnati, OH
  • NPI 1962745083
  Medicare reassignment Care Compare group NPD
• Supportive Healthcare Skilled LLC

  • Family Nurse Practitioner
  • Cincinnati, OH
  • NPI 1316838352
  Medicare reassignment NPD

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

{
    "created_epoch": "1741305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1740089382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4850 SMITH RD STE 250",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452122733",
            "telephone_number": "513-231-1060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 SMITH RD STE 250",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452122733",
            "telephone_number": "704-776-5577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETILLION",
        "first_name": "GWENDOLYN",
        "middle_name": "L",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-07",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "F03250051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karin J Detchon, RN, CNP
• Nicholas Ross Detchon, CRNA
• Delaney Elizabeth Deters, PA-C
• Janet L Deters, PT
• Abigail Detherage
• Jill Marie Detling
• Amy Cecelia Detoro, CNP
• Beth A Detrich, MSW, LISW-S
• Amie Nicole Detzel
• Jennifer J Detzel, RN, CNP

• Family Nurse Practitioner in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.