Individual provider Active NPI

Phyllis J Atkinson, NP

  • Gerontology Nurse Practitioner
  • Maineville, OH
National Provider Identifier
1992849509
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
02537 Issued in OH
Practice address
954 Sedgefield CT
Maineville, OH 45039-7513
Phone
(513) 275-6551
Fax
(513) 275-6557
NPI assigned
Feb 16, 2007
Last updated
Feb 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 02537 OH Primary

Addresses

Primary practice location

954 Sedgefield CT
Maineville, OH 45039-7513

Mailing address

PO Box 1060
Uniontown, OH 44685-1060
Phone (513) 275-6551

Other practice location 1

2114 Chamber Center Dr
Lakeside Park, KY 41017-1669
Phone (513) 878-0907

Other practice location 2

725 University Blvd
Beavercreek, OH 45324-2640
Phone (937) 245-7200

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
I20070402000531 OH Practitioner - Nurse Practitioner 4284738121 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Ohio State University College of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Senectum Medical Group LLCGroup PAC ID 2062859994, 3 clinicians

Practice addresses (Care Compare)

954 Sedgefield CT
Maineville, OH 45039-7513
Phone (513) 275-6551

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2861KYMDSpeech-Language Pathologist
02537OHMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mills Medical Practices, LLC CurrentSince Apr 1, 2017 Accepting new patients
Senectum Medical Group LLC Gerontology CurrentSince Jan 8, 2024 Accepting new patients
Wright State Physicians Inc Past Accepting new patients
University of Cincinnati Physicians Company, LLC Past Accepting new patients

Locations

805 N Whittington Pkwy
Ste 200
Louisville, KY 40222

805 N Whittington Pkwy
Northfield, KY 40222
Phone (502) 627-7000

3733 Park East Dr
Ste 220
Beachwood, OH 44122
Phone (440) 368-6868

3737 Park East Dr
Ste 220
Beachwood, OH 44122
Phone (440) 368-6868

4401 Rockside Rd
Ste 214
Independence, OH 44131
Phone (216) 642-1297

30575 Bainbridge Rd
Ste 300
Solon, OH 44139
Phone (216) 800-7137

Organizations & group practices 4

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 9

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": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1992849509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1060",
            "city": "UNIONTOWN",
            "state": "OH",
            "postal_code": "446851060",
            "telephone_number": "513-275-6551",
            "fax_number": "513-275-6557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "954 SEDGEFIELD CT",
            "city": "MAINEVILLE",
            "state": "OH",
            "postal_code": "450397513",
            "telephone_number": "513-275-6551",
            "fax_number": "513-275-6557"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2114 Chamber Center Dr",
            "address_purpose": "LOCATION",
            "city": "Lakeside Park",
            "state": "KY",
            "postal_code": "410171669",
            "country_code": "US",
            "telephone_number": "513-878-0907",
            "fax_number": "513-878-0908",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "725 University Blvd",
            "address_purpose": "LOCATION",
            "city": "Beavercreek",
            "state": "OH",
            "postal_code": "453242640",
            "country_code": "US",
            "telephone_number": "937-245-7200",
            "fax_number": "937-245-7999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ATKINSON",
        "first_name": "PHYLLIS",
        "middle_name": "J",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-16",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OH",
            "license": "02537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maineville, OH

Sources for this page

Verify at the official NPI Registry.