Individual provider Active NPI

Mikyong Suh, MSN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Toledo, OH
National Provider Identifier
1851721377
Registry record updated Nov 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
COA15300NP Issued in OH
Practice address
1425 Starr Ave
Toledo, OH 43605-2456
Phone
(419) 693-0631
Fax
(419) 936-7606
NPI assigned
Nov 19, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2013

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 COA15300NP OH Primary

Addresses

Primary practice location

1425 Starr Ave
Toledo, OH 43605-2456

Mailing address

1425 Starr Ave
Toledo, OH 43605-2456
Phone (419) 693-0631

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
I20131207000117 OH Practitioner - Nurse Practitioner 3476780974 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1425 Starr Ave
Toledo, OH 43605-2456

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
COA15300NPOHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Unison Behavioral Health Group, Inc. CurrentSince Nov 1, 2013 Accepting new patients

Locations

1425 Starr Ave
Toledo, OH 43605
Phone (419) 259-4506

544 E Woodruff Ave
Toledo, OH 43604
Phone (419) 214-4673

Organizations & group practices 1

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": "1384819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384819200000",
    "number": "1851721377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 STARR AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436052456",
            "telephone_number": "419-693-0631",
            "fax_number": "419-936-7606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 STARR AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436052456",
            "telephone_number": "419-693-0631",
            "fax_number": "419-936-7606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUH",
        "first_name": "MIKYONG",
        "name_prefix": "Miss",
        "credential": "MSN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-19",
        "last_updated": "2013-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "COA15300NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.