Individual provider Active NPI

Mark A Washam, NP

  • Nurse Practitioner
  • Cincinnati, OH
National Provider Identifier
1831475649
Registry record updated Aug 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN.CNP.12015 Issued in OH
Practice address
3333 Burnet Ave
ML 11024
Cincinnati, OH 45229-3026
Phone
(513) 636-0375
Fax
(513) 803-1124
NPI assigned
Oct 25, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3006743 KY
Family Nurse Practitioner 363LF0000X 3006743 KY
Nurse Practitioner 363L00000X APRN.CNP.12015 OH Primary

Addresses

Primary practice location

3333 Burnet Ave
ML 11024
Cincinnati, OH 45229-3026

Mailing address

3333 Burnet Ave
ML 11024
Cincinnati, OH 45229-3026
Phone (513) 636-0375

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
I20150518002230 OH Practitioner - Nurse Practitioner 3779759832 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CNP.12015OHMDNurse Practitioner
COA12015-NPOHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital Medical Center Nurse Practitioner CurrentSince Apr 12, 2015 Accepting new patients
CHMC Community Health Services Network Past Accepting new patients

Locations

3341 Solutions Ctr
Chicago, IL 60677

636 Prospect Pl
Cincinnati, OH 45229
Phone (513) 363-5500

2515 Clifton Ave
Cincinnati, OH 45219
Phone (513) 363-7554

3333 Burnet Ave
Cincinnati, OH 45229
Phone (513) 636-4200

3333 Burnet Ave
#5021
Cincinnati, OH 45229
Phone (513) 636-4225

335 Rockdale Ave
Cincinnati, OH 45229
Phone (513) 363-4700

3333 Burnet Ave
#11024
Cincinnati, OH 45229
Phone (513) 803-0375

Organizations & group practices 2

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": "1319500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1831475649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE",
            "address_2": "ML 11024",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293026",
            "telephone_number": "513-636-0375",
            "fax_number": "513-803-1124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE",
            "address_2": "ML 11024",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293026",
            "telephone_number": "513-636-0375",
            "fax_number": "513-803-1124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASHAM",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-25",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3006743",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3006743",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.12015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.