Madison Lange
Individual provider Active NPI Nurse Practitioner · Cincinnati, OH
NPI 1750128591 · NPPES record last updated Jul 30, 2024
Key facts
- NPI
- 1750128591
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- APRN.CNP.0037173 (OH)
- Practice address
- 3188 Bellevue Ave
Cincinnati, OH 45219-2369 - Phone
- (513) 584-1000
- Fax
- (513) 475-7480
- NPI assigned
- Jul 10, 2024
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- University of Cincinnati Physicians Company LLC
Practice addresses (Care Compare)
3188 Bellevue Ave
Cincinnati, OH 45219-2369
Phone (513) 584-1000
Hospital & facility affiliations
- University of Cincinnati Medical Center, LLC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240925002954 | OH | Practitioner - Nurse Practitioner | 8325589708 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 258553 | TN | MD | Internal Medicine Physician |
| APRN.CNP.0037173 | OH | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Cincinnati Medical Center, LLC | Nurse Practitioner | Current | Accepting new patients |
| University of Cincinnati Physicians Company, LLC | Internal Medicine | Current |
Accepting new patients |
Locations
3188 Bellevue Ave
Cincinnati, OH 45219
Phone (513) 558-5281
2123 Auburn Ave
#A28
Cincinnati, OH 45219
Phone (513) 585-0523
3200 Burnet Ave
Cincinnati, OH 45229
Phone (513) 558-7700
200 Albert Sabin Way
Fl 3
Cincinnati, OH 45267
Phone (513) 475-7500
3200 Burnet Ave
#2
Cincinnati, OH 45229
Phone (513) 585-5505
7675 Wellness Way
Ste 211
West Chester, OH 45069
Phone (513) 475-7561
7700 University Dr
West Chester, OH 45069
Phone (513) 298-3000
7700 University Dr
Ste 3500
West Chester, OH 45069
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 258553 | TN | |
| Nurse Practitioner | 363L00000X | APRN.CNP.0037173 | OH | Yes |
Addresses
Primary practice location
3188 Bellevue Ave
Cincinnati, OH 45219-2369
Mailing address
PO Box 636256
Cincinnati, OH 45263-6256
Phone (513) 585-6200
Other practice location 1
1265 Union Ave
Memphis, TN 38104-3415
Phone (859) 801-2106
NPI Registry JSON
{
"created_epoch": "1720569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722297600000",
"number": "1750128591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 636256",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452636256",
"telephone_number": "513-585-6200",
"fax_number": "513-245-3672"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3188 BELLEVUE AVE",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452192369",
"telephone_number": "513-584-1000",
"fax_number": "513-475-7480"
}
],
"practiceLocations": [
{
"address_1": "1265 Union Ave",
"address_purpose": "LOCATION",
"city": "Memphis",
"state": "TN",
"postal_code": "381043415",
"country_code": "US",
"telephone_number": "859-801-2106",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LANGE",
"first_name": "MADISON",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-07-10",
"last_updated": "2024-07-30",
"certification_date": "2024-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TN",
"license": "258553",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "OH",
"license": "APRN.CNP.0037173",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Cincinnati, OH
- Michelle Langdon
- David William Lange
- David William Lange
- Jessica Lange
- Lana Lange
- Magdalena Lange
- Jennifer Lynn Langen
- Dana Langenbrunner
- Matthew A Langenderfer
- Rachel A Langenderfer
All providers in Cincinnati, OH · Nurse Practitioner in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 30, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.