Individual provider Active NPI

Mary Jo Pollock, CNS

  • Psychiatric/Mental Health Nurse Practitioner
  • Mason, OH
National Provider Identifier
1790865681
Registry record updated Aug 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN116239 Issued in OH
Practice address
4075 Old Western Row Rd
Mason, OH 45040-3104
Phone
(513) 536-0600
Fax
(513) 536-0619
NPI assigned
Oct 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN116239 OH Primary

Addresses

Primary practice location

4075 Old Western Row Rd
Mason, OH 45040-3104

Mailing address

4075 Old Western Row Rd
Mason, OH 45040-3104
Phone (513) 536-0600

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
I20050104000477 OH Practitioner - Certified Clinical Nurse Specialist (CNS) 9931157278 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lindner Center of Hope Professional AssociatesGroup PAC ID 7012236409, 72 clinicians

Practice addresses (Care Compare)

4075 Old Western Row Rd
Mason, OH 45040-3104
Phone (513) 536-4673

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN116239OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Craig and Frances Lindner Center of Hope CurrentSince Aug 18, 2008 Accepting new patients
Lindner Center of Hope Professional Associates CurrentSince Mar 17, 2015 Accepting new patients
Psychiatric Professional Services Psychiatric/Mental Health Past Accepting new patients

Locations

9435 Waterstone Blvd
Ste 120
Cincinnati, OH 45249
Phone (513) 536-0639

4075 Old Western Row Rd
Mason, OH 45040
Phone (513) 536-0232

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.

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439510400000",
    "number": "1790865681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4075 OLD WESTERN ROW RD",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450403104",
            "telephone_number": "513-536-0600",
            "fax_number": "513-536-0619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4075 OLD WESTERN ROW RD",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450403104",
            "telephone_number": "513-536-0600",
            "fax_number": "513-536-0619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLOCK",
        "first_name": "MARY JO",
        "credential": "CNS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2015-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "RN116239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mason, OH

Sources for this page

Verify at the official NPI Registry.