Medical Housecalls LLC
Organization Active NPI Family Nurse Practitioner · Cincinnati, OH
NPI 1962745083 · NPPES record last updated Sep 3, 2024
Key facts
- NPI
- 1962745083
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- Legal business name
- MEDICAL HOUSECALLS LLC
- Practice address
- 4850 Smith Rd Ste 250
Cincinnati, OH 45212-2796 - Phone
- (513) 699-9090
- NPI assigned
- Mar 27, 2013
- Organization subpart
- No
Authorized official
- Name
- Joshua Holzman
- Title
- Ceo
- Phone
- (513) 699-9090
Member organizations 1
Practitioners 81
-
Kofi Ansah, MD
-
Stephanie Lauren Avdagic, DNP, APRN, FNP-BC
-
Lauren Elizabeth Bechtel, APRN, FNP-BC
-
Susanne Ficht Bond, CNP
-
Linda S Brodbeck, NP-C
-
Gwendolyn L Detillion, FNP-C
-
Omar Ramos Diaz, MSN, NP-C
-
Meghan Elizabeth Dozier, APRN
-
Carole Evans, NP
-
Courtney Foust, APRN
-
Oksana Gordeyeva, CNP
-
Tavissa Granger, PMHNP-BC
-
Victoria Green, APRN, CNP
-
Leah Guthrie, APRN PMHNP
-
Rachel F Harris, APRN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in OH, KY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130523000367 | OH | Part B Supplier - Clinic/Group Practice | 6709024268 |
Receives reassigned benefits from 76 practitioners Practice locations: Cincinnati, OH; Dayton, OH; Salem, OH |
| O20240729002276 | KY | Part B Supplier - Clinic/Group Practice | 6709024268 |
Receives reassigned benefits from 10 practitioners Practice locations: Augusta, KY; Erlanger, KY; Falmouth, KY; Florence, KY; Fort Thomas, KY; Ft Wright, KY; Villa Hills, KY |
National Provider Directory
Locations
4055 Executive Park Dr
Ste 115
Cincinnati, OH 45241
Phone (513) 531-9600
1055 State Route 125
Cincinnati, OH 45245
Phone (513) 449-3900
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner |
363LF0000X | Yes |
Addresses
Primary practice location
4850 Smith Rd Ste 250
Cincinnati, OH 45212-2796
Mailing address
PO Box 32160
Dept 107
Louisville, KY 40232-2160
Phone (513) 699-9090
Other practice location 1
630 W Main St Ste 209
Wilmington, OH 45177-2181
Phone (937) 383-2700
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0082482 | Medicaid | OH |
Other names
- Supportive Healthcare
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All providers in Cincinnati, OH · Family Nurse Practitioner in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 3, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.