GWENDOLYN L DETILLION FNP-C
NPI 1740089382
Nurse Practitioner - Family in Cincinnati, OH

Q: What is Gwendolyn Detillion's NPI number?

The NPI number for Gwendolyn Detillion is 1740089382. It was assigned to this individual provider in the NPPES registry on March 7, 2025.

Q: What is Gwendolyn Detillion's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Active since March 07, 2025PECOS EnrolledAccepts Medicare Assignment

4850 SMITH RD STE 250, CINCINNATI, OH 45212(704) 776-5577 Get Directions Write a Review

NPPES record last updated: April 10, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 10, 2025, Mar 7, 2025 (2 updates tracked since 2025).

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About Gwendolyn L Detillion Fnp-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GWENDOLYN L DETILLION FNP-C (NPI 1740089382) is an individual family provider in Cincinnati, Ohio, licensed in Ohio (F03250051) and active in the NPI registry since March 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1740089382

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameGWENDOLYN L DETILLIONCredential: FNP-C

Location Address4850 SMITH RD STE 250Cincinnati, OH 45212-2733

Mailing Address4850 Smith Rd Ste 250Cincinnati, OH 45212-2733 · (513) 231-1060

Phone(704) 776-5577

Sole ProprietorNo

Medical School CMSOtherGraduated 2024

Enumeration DateMarch 7, 2025

Last NPPES UpdateApril 10, 20252 updates tracked since enumeration

NPPES CertifiedApril 10, 2025

✔ NPI 1740089382 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in OH · F03250051

4850 SMITH RD STE 250, Cincinnati, OH 45212

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, Molina Healthcare, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Gwendolyn L Detillion Fnp-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6406379916

PECOS Enrollment IDI20250325003471

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45212 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.72 typical visit price

range $54.34 – $166.65

Typical copayment $21.18 (range $13.58 – $41.66)

Most-billed visit code 99203

Established Patient

$96.44 typical visit price

range $17.10 – $135.40

Typical copayment $24.11 (range $4.27 – $33.85)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TAVISSA GRANGER PMHNP-BC

Nurse Practitioner (Psychiatric/Mental Health)