Individual provider Active NPI

Jessica Nicole Lewis, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Xenia, OH
National Provider Identifier
1972302354
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN.CNP.0038842 Issued in OH
Practice address
36 N Detroit St
Xenia, OH 45385-2909
Phone
(513) 914-4673
NPI assigned
Mar 10, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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.0038842 OH Primary

Addresses

Primary practice location

36 N Detroit St
Xenia, OH 45385-2909

Mailing address

100 Crowne Point PL
Cincinnati, OH 45241-5427
Phone (513) 743-7628

Other practice location 1

302 W Main St
Fairborn, OH 45324-5037
Phone (937) 281-4673

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
I20250828004050 OH Practitioner - Nurse Practitioner 8628579976 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Decoach Team LLCGroup PAC ID 7517244551, 16 clinicians

Practice addresses (Care Compare)

36 N Detroit St
Xenia, OH 45385-2909
Phone (937) 610-4673

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Decoach Team LLC CurrentSince Jun 23, 2025 Accepting new patients
Decoach Team LLC CurrentSince Apr 1, 2021 Accepting new patients

Locations

1620 Harrison Ave
Cincinnati, OH 45214
Phone (513) 892-4673

865 S Patterson Blvd
Dayton, OH 45402
Phone (937) 966-4673

2172 US Route 127 N
Eaton, OH 45320
Phone (937) 456-5811

6570 Sosna Dr
Fairfield, OH 45014
Phone (513) 942-4673

3103 Dixie Hwy
Hamilton, OH 45015
Phone (513) 892-4673

100 Crowne Point Pl
Sharonville, OH 45241
Phone (513) 743-7628

36 N Detroit St
Xenia, OH 45385
Phone (937) 610-4673

36 N Detroit St
Ste 105
Xenia, OH 45385
Phone (513) 942-4673

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1741564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1972302354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CROWNE POINT PL",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452415427",
            "telephone_number": "513-743-7628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 N DETROIT ST",
            "city": "XENIA",
            "state": "OH",
            "postal_code": "453852909",
            "telephone_number": "513-914-4673"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "302 W Main St",
            "address_purpose": "LOCATION",
            "city": "Fairborn",
            "state": "OH",
            "postal_code": "453245037",
            "country_code": "US",
            "telephone_number": "937-281-4673",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "JESSICA",
        "middle_name": "NICOLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-10",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0038842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Xenia, OH

Sources for this page

Verify at the official NPI Registry.