Individual provider Active NPI

Jonathan Thomas Gully, M.D.

  • Family Medicine Physician
  • Cincinnati, OH
National Provider Identifier
1740574342
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35130516 Issued in OH
Practice address
212 W Sharon Rd
Cincinnati, OH 45246-4137
Phone
(513) 771-7213
Fax
(513) 771-4356
NPI assigned
Jun 1, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35130516 OH Primary

Addresses

Primary practice location

212 W Sharon Rd
Cincinnati, OH 45246-4137

Mailing address

3231 Euclid Ave
5TH Floor
Berwyn, IL 60402-3471
Phone (708) 783-2000

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170830001809 OH Practitioner - Family Practice 8325271828 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Physicians Cincinnati LLCGroup PAC ID 6709790892, 191 clinicians

Practice addresses (Care Compare)

212 W Sharon Rd
Cincinnati, OH 45246-4137
Phone (513) 771-7213

Hospital & facility affiliations

  • Mercy Health - West Hospital Hospital, Cincinnati, OH, CCN 360234
  • Mercy Health - Fairfield Hospital Hospital, Fairfield, OH, CCN 360056
  • The Jewish Hospital-Mercy Health Hospital, Cincinnati, OH, CCN 360016
  • Bethesda North Hospital, Cincinnati, OH, CCN 360179

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Cincinnati LLC CurrentSince Oct 1, 2017 Accepting new patients
Mercy Health Physicians Cincinnati, LLC Family Medicine CurrentSince Oct 1, 2017 Accepting new patients
Proctor Health Systems Family Medicine Past Accepting new patients

Locations

2446 Kipling Ave
Cincinnati, OH 45239
Phone (513) 583-8500

212 W Sharon Rd
Cincinnati, OH 45246
Phone (513) 771-7213

Interoperability endpoints

  • Direct secure messaging: jgully356524@direct.bsmhealth.org

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1306886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1740574342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3231 EUCLID AVE",
            "address_2": "5TH FLOOR",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023471",
            "telephone_number": "708-783-2000",
            "fax_number": "708-783-3656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 W SHARON RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452464137",
            "telephone_number": "513-771-7213",
            "fax_number": "513-771-4356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULLY",
        "first_name": "JONATHAN",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-01",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35130516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.