Individual provider Active NPI

Jose S Parra, CNP

  • Family Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1740725506
Registry record updated Oct 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.020356 Issued in OH
Practice address
16 W Long St
Columbus, OH 43215-2815
Phone
(614) 225-0990
Fax
(614) 225-0991
NPI assigned
Jan 3, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.020356 OH Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2022025851 OH

Addresses

Primary practice location

16 W Long St
Columbus, OH 43215-2815

Mailing address

16 W Long St
Columbus, OH 43215-2815
Phone (614) 225-0990

Other practice location 1

111 S Grant Ave
Columbus, OH 43215-4701
Phone (614) 566-8883

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
I20170203001873 OH Practitioner - Nurse Practitioner 8123301884 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeast IncGroup PAC ID 8426014853, 48 clinicians

Practice addresses (Care Compare)

16 W Long St
Columbus, OH 43215-2815
Phone (614) 225-0990

524 W Broad St
Columbus, OH 43215-2775
Phone (614) 225-0980

720 E Broad St
Suite 101
Columbus, OH 43215-3989
Phone (614) 360-0122

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2022025851OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation CurrentSince Feb 1, 2017 Accepting new patients
Southeast, Inc CurrentSince Jan 1, 2024 Accepting new patients
Southeast, Inc CurrentSince Jan 1, 2024 Accepting new patients
Ohiohealth Corporation CurrentSince Feb 1, 2017 Accepting new patients

Locations

111 S Grant Ave
Columbus, OH 43215
Phone (614) 461-3232

Dept L3652
Columbus, OH 43260

16 W Long St
Columbus, OH 43215

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

5400 Frantz Rd
Ste 250
Dublin, OH 43016
Phone (614) 544-6161

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1483401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665360000000",
    "number": "1740725506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 W LONG ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432152815",
            "telephone_number": "614-225-0990",
            "fax_number": "614-225-0991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 W LONG ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432152815",
            "telephone_number": "614-225-0990",
            "fax_number": "614-225-0991"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 S Grant Ave",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432154701",
            "country_code": "US",
            "telephone_number": "614-566-8883",
            "fax_number": "614-566-8149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARRA",
        "first_name": "JOSE",
        "middle_name": "S",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-01-03",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.020356",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "2022025851",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.