Individual provider Active NPI

Sheryl List, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Cincinnati, OH
National Provider Identifier
1962020875
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN.CNP.0026892 Issued in OH
Practice address
4015 Executive Park Dr Ste 320
Cincinnati, OH 45241-4015
Phone
(513) 563-0488
NPI assigned
Jul 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 3018525 KY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN.CNP.0026892 OH Primary

Addresses

Primary practice location

4015 Executive Park Dr Ste 320
Cincinnati, OH 45241-4015

Mailing address

2103 Madison Dr
Hebron, KY 41048-7399
Phone (859) 444-2286

Other practice location 1

2103 Madison Dr
Hebron, KY 41048-7399
Phone (859) 444-2286

Other identifiers 1

IdentifierTypeStateIssuer
0415158MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, KY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200819004006 OH Practitioner - Nurse Practitioner 9032535125 Reassigns benefits to 1 organization
I20230117001030 KY Practitioner - Nurse Practitioner 9032535125 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Neuropsych Center of Greater Cincinnati LLCGroup PAC ID 2567754815, 17 clinicians

Practice addresses (Care Compare)

4015 Executive Park Dr
Suite 320
Cincinnati, OH 45241-4015
Phone (513) 563-0488

7699 US Hwy 42
Florence, KY 41042-1909
Phone (513) 563-0488

Hospital & facility affiliations

  • Good Samaritan Hospital Hospital, Cincinnati, OH, CCN 360134

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3018525KYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Neuropsych Center of Greater Cincinnati LLC CurrentSince Dec 8, 2024 Accepting new patients
Neuropsych Center of Greater Cincinnati LLC Psychiatry CurrentSince Aug 7, 2020 Accepting new patients
Neuropsych Center of Greater Cincinnati Past Accepting new patients

Locations

7699 US Route 42
Florence, KY 41042
Phone (513) 563-0488

4015 Executive Park Dr
Ste 320
Cincinnati, OH 45241
Phone (513) 563-0488

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.

Hospital & facility affiliations 5

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": "1594080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1962020875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2103 MADISON DR",
            "city": "HEBRON",
            "state": "KY",
            "postal_code": "410487399",
            "telephone_number": "859-444-2286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4015 EXECUTIVE PARK DR STE 320",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452414015",
            "telephone_number": "513-563-0488"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2103 Madison Dr",
            "address_purpose": "LOCATION",
            "city": "Hebron",
            "state": "KY",
            "postal_code": "410487399",
            "country_code": "US",
            "telephone_number": "859-444-2286",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIST",
        "first_name": "SHERYL",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-07",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3018525",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0026892",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0415158",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.