Individual provider Active NPI

Gretchen Elaine Mogle, APRN

  • Family Nurse Practitioner
  • Bellbrook, OH
National Provider Identifier
1962037382
Registry record updated Jul 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
026462 Issued in OH
Practice address
1930 N Lakeman Dr Ste 109
Bellbrook, OH 45305-1200
Phone
(937) 203-3079
Fax
(937) 886-6609
NPI assigned
Mar 5, 2020
Last updated
Jul 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2021

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 026462 OH Primary

Addresses

Primary practice location

1930 N Lakeman Dr Ste 109
Bellbrook, OH 45305-1200

Mailing address

1930 N Lakeman Dr Ste 109
Bellbrook, OH 45305-1200
Phone (937) 203-3079

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
I20200605000243 OH Practitioner - Nurse Practitioner 4183045891 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Weller Health TransitionsGroup PAC ID 2567771041, 7 clinicians
Pai Participant 1 LLCGroup PAC ID 8123351954, 174 clinicians

Practice addresses (Care Compare)

1 Country LN
Brookville, OH 45309-9268
Phone (937) 203-3079

230 Cherry St
Chillicothe, OH 45601-2301
Phone (740) 773-6470

350 Union Blvd
Englewood, OH 45322-2196
Phone (937) 203-3079

81 S Stanfield Rd
Troy, OH 45373-2337
Phone (937) 203-3079

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
026462OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pai Participant 1 LLC CurrentSince Oct 12, 2020 Accepting new patients
Weller Health Transitions, LLC CurrentSince Mar 1, 2020 Accepting new patients

Locations

1930 N Lakeman Dr
Ste 109
Bellbrook, OH 45305
Phone (937) 203-3079

230 Cherry St
Chillicothe, OH 45601
Phone (740) 773-6470

4000 Singing Hills Blvd
Dayton, OH 45414
Phone (513) 707-1546

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 2

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": "1583366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625184000000",
    "number": "1962037382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 N LAKEMAN DR STE 109",
            "city": "BELLBROOK",
            "state": "OH",
            "postal_code": "453051200",
            "telephone_number": "937-203-3079",
            "fax_number": "937-886-6609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 N LAKEMAN DR STE 109",
            "city": "BELLBROOK",
            "state": "OH",
            "postal_code": "453051200",
            "telephone_number": "937-203-3079",
            "fax_number": "937-886-6609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOGLE",
        "first_name": "GRETCHEN",
        "middle_name": "ELAINE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-05",
        "last_updated": "2021-07-02",
        "certification_date": "2021-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "026462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellbrook, OH

Sources for this page

Verify at the official NPI Registry.