Individual provider Active NPI

Elizabeth Brannen

  • Family Nurse Practitioner
  • Ft Mitchell, KY
National Provider Identifier
1841905494
Registry record updated Jan 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.0031468 Issued in OH
Practice address
110 Burdsall Ave
Fort Mitchell, KY 41017-2824
Phone
(859) 486-3319
NPI assigned
Jan 18, 2023
Last updated
Jan 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.0031468 OH Primary

Addresses

Primary practice location

110 Burdsall Ave
Fort Mitchell, KY 41017-2824

Mailing address

110 Burdsall Ave
Fort Mitchell, KY 41017-2824

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
I20240216000949 OH Practitioner - Nurse Practitioner 9032553110 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Ohio State University College of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Radiology IncGroup PAC ID 0941298764, 41 clinicians

Practice addresses (Care Compare)

4777 E Galbraith Rd
Cincinnati, OH 45236-2725
Phone (513) 872-4500

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Radiology Inc. CurrentSince Jan 2, 2024 Accepting new patients
Professional Raadiology Inc Past Accepting new patients

Locations

9825 Kenwood Rd
Ste 105
Blue Ash, OH 45242
Phone (513) 527-0408

2139 Auburn Ave
Cincinnati, OH 45219
Phone (513) 585-0406

4777 E Galbraith Rd
Cincinnati, OH 45236
Phone (513) 686-3000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1674000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1841905494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 BURDSALL AVE",
            "city": "FORT MITCHELL",
            "state": "KY",
            "postal_code": "410172824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 BURDSALL AVE",
            "city": "FORT MITCHELL",
            "state": "KY",
            "postal_code": "410172824",
            "telephone_number": "859-486-3319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANNEN",
        "first_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-18",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0031468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Mitchell, KY

Sources for this page

Verify at the official NPI Registry.