Individual provider Active NPI

Michael James Billock

  • Psychiatric/Mental Health Nurse Practitioner
  • Dublin, OH
National Provider Identifier
1962164046
Registry record updated Mar 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN.CNP.0029929 Issued in OH
Practice address
525 Metro PL N Ste 100
Dublin, OH 43017-5343
Phone
(855) 289-1722
NPI assigned
Oct 6, 2021
Last updated
Mar 17, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2023

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 APRN.CNP.0029929 OH Primary

Addresses

Primary practice location

525 Metro PL N Ste 100
Dublin, OH 43017-5343

Mailing address

525 Metro PL N Ste 100
Dublin, OH 43017-5343
Phone (855) 289-1722

Other practice location 1

3926 Bryant Dr
Youngstown, OH 44511-1156
Phone (330) 719-6675

Other identifiers 1

IdentifierTypeStateIssuer
2910854MedicaidOH

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
I20211123001048 OH Practitioner - Nurse Practitioner 7719376284 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

525 Metro PL N
Suite 300
Dublin, OH 43017-5320
Phone (855) 289-1722

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0029929OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family & Community Services Inc Current Accepting new patients
Family & Community Services, Inc CurrentSince Nov 1, 2021 Accepting new patients

Locations

150 E Market St
Warren, OH 44481
Phone (330) 394-6244

4970 Belmont Ave
Youngstown, OH 44505
Phone (330) 759-8237

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1633478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1962164046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 METRO PL N STE 100",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430175343",
            "telephone_number": "855-289-1722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 METRO PL N STE 100",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430175343",
            "telephone_number": "855-289-1722"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3926 Bryant Dr",
            "address_purpose": "LOCATION",
            "city": "Youngstown",
            "state": "OH",
            "postal_code": "445111156",
            "country_code": "US",
            "telephone_number": "330-719-6675",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BILLOCK",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-06",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0029929",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2910854",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, OH

Sources for this page

Verify at the official NPI Registry.