Lee Side Wellness Associates, Llc | |
3615 Socialville Foster Rd Suties A B C D Mason OH 45040-6971 | |
(513) 204-1910 | |
(513) 204-0049 |
Full Name | Lee Side Wellness Associates, Llc |
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Speciality | Nurse Practitioner |
Location | 3615 Socialville Foster Rd, Mason, Ohio |
Authorized Official Name and Position | Ronald Tyson (OWNER/CEO) |
Authorized Official Contact | 5133170720 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Lee Side Wellness Associates, Llc 3615 Socilaville Foster Rd Suites A B C D Mason OH 45040-6971 Ph: (513) 204-1910 | Lee Side Wellness Associates, Llc 3615 Socialville Foster Rd Suties A B C D Mason OH 45040-6971 Ph: (513) 204-1910 |
NPI Number | 1841731510 |
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Provider Enumeration Date | 03/15/2017 |
Last Update Date | 05/17/2022 |
Certification Date | 05/17/2022 |
Medicare PECOS PAC ID | 4587934823 |
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Medicare Enrollment ID | O20170719003872 |
Identifier | Type | State | Issuer |
---|---|---|---|
1841731510 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
Provider Name | Kathie Jo Turner |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1457498495 PECOS PAC ID: 2860390457 Enrollment ID: I20031219000817 |
Provider Name | Mary Harrison |
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Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
Provider Identifiers | NPI Number: 1629006721 PECOS PAC ID: 2769468123 Enrollment ID: I20040625001077 |
Provider Name | Dominic Gomes |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1144376856 PECOS PAC ID: 8820040298 Enrollment ID: I20050214000616 |
Provider Name | James Shackson |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1831185545 PECOS PAC ID: 9638170756 Enrollment ID: I20070116000360 |
Provider Name | Cynthia L Tufarella |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1649584814 PECOS PAC ID: 1052500808 Enrollment ID: I20110107001100 |
Provider Name | Ronald Lee Tyson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1891091468 PECOS PAC ID: 8820271323 Enrollment ID: I20110321000891 |
Provider Name | Lisa N Schauseil |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1346518222 PECOS PAC ID: 1052578507 Enrollment ID: I20120210000462 |
Provider Name | Julie M Stone |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1477803419 PECOS PAC ID: 1557512266 Enrollment ID: I20121106000188 |
Provider Name | Ashley C Altman |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1528308764 PECOS PAC ID: 9638319437 Enrollment ID: I20130627000590 |
Provider Name | Rachel M Cash |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1245564095 PECOS PAC ID: 3678709888 Enrollment ID: I20131118001159 |
Provider Name | Misty M Richmond |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1154744290 PECOS PAC ID: 1557591765 Enrollment ID: I20140310001693 |
Provider Name | Meghan M Gossett |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1356749998 PECOS PAC ID: 6800111097 Enrollment ID: I20150210002052 |
Provider Name | Lavinda D Mcauliffe |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1629523816 PECOS PAC ID: 9032490842 Enrollment ID: I20170109002942 |
Provider Name | Teaera Roland |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1114468261 PECOS PAC ID: 1850666314 Enrollment ID: I20171009003443 |
Provider Name | Tiffany Price |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1699203620 PECOS PAC ID: 3476813288 Enrollment ID: I20180215001464 |
Provider Name | Emilie A Breeding |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1174077333 PECOS PAC ID: 2567717887 Enrollment ID: I20180608001712 |
Provider Name | Ashley Jean Gould |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1386130094 PECOS PAC ID: 2365793692 Enrollment ID: I20180925002724 |
Provider Name | Amanda Hardesty |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1275954109 PECOS PAC ID: 2163850876 Enrollment ID: I20200311002168 |
Provider Name | Tiffonie Lynn Caudill |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1699373696 PECOS PAC ID: 1557773199 Enrollment ID: I20201223001687 |
Provider Name | Lori R Morgan |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1902495195 PECOS PAC ID: 3870908874 Enrollment ID: I20210225002221 |
Provider Name | Eric C Adams |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1427719699 PECOS PAC ID: 2062891484 Enrollment ID: I20220615001402 |
Provider Name | Akosua B Ankomah |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1437816246 PECOS PAC ID: 8123409877 Enrollment ID: I20220713001088 |
Provider Name | Summer Wilson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1285827949 PECOS PAC ID: 8022491489 Enrollment ID: I20220817002138 |
Provider Name | Becky Hodges |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1467237800 PECOS PAC ID: 4688022601 Enrollment ID: I20231130002117 |
Provider Name | Heidi N Karle |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1326709890 PECOS PAC ID: 6204289721 Enrollment ID: I20240131001828 |
Provider Name | Olubanke Olatundun Adesanya |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1518695691 PECOS PAC ID: 1658724133 Enrollment ID: I20240131003879 |
Provider Name | Teara Gruber |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1316703663 PECOS PAC ID: 0840632089 Enrollment ID: I20240520003331 |
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