LATONIA YVETTE CUSHINGBERRY (FNP) – Family Nurse Practitioner, NPI 1104200716

LATONIA YVETTE CUSHINGBERRY (FNP) is a healthcare provider. based in Fairfield, Ohio. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP. They hold a License No. F07155500 (OH). The NPI Number for LATONIA YVETTE CUSHINGBERRY (FNP) is 1104200716

Main info

Female
11 Years Of Experience
Accepts Medicare Assignment
Name
LATONIA YVETTE CUSHINGBERRY (FNP)
NPI
1104200716
Phone
(513) 628-0627
Address
154 TWIN LAKES DR
Enumeration Date
13 July 2015
Last Update Date
13 July 2015

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5137726166
Graduation Year
2015 (11 years ago)
PAC ID
8628376563
Group Practice PAC ID
7719258292
Professional Enrollment ID
I20230829000450
Address ID
OH452415816CI11156RDXX301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:10State licenses:1Digital endpointsOther names

14,984 NURSE PRACTITIONER in OH

Provider Addresses for LATONIA YVETTE CUSHINGBERRY (FNP)

  • 154 TWIN LAKES DR

    FAIRFIELD, OH 450145257

    Phone: (513) 628-0627

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-08-29

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230829000450INurse PractitionerOHTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 45014)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7719258292View full group profile
NameSpecialtyState
Mental Health CounselorOH
Mental Health CounselorOH
Clinical Social WorkerOH
Clinical Social WorkerKY
Clinical Social WorkerOH
-OH
Clinical Social WorkerOH
Nurse PractitionerOH
Clinical Social WorkerOH
-OH

Reviews

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Frequently asked questions

Is there an official ID for LATONIA YVETTE CUSHINGBERRY (FNP) in U.S. healthcare records?
The official identifier for LATONIA YVETTE CUSHINGBERRY (FNP) is NPI 1104200716.
Is LATONIA YVETTE CUSHINGBERRY (FNP) still an active registrant?
LATONIA YVETTE CUSHINGBERRY (FNP) carries an active NPI according to the public dataset.
What clinical focus is listed for LATONIA YVETTE CUSHINGBERRY (FNP)?
At a glance, LATONIA YVETTE CUSHINGBERRY (FNP) is tied to Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What practice footprint exists for LATONIA YVETTE CUSHINGBERRY (FNP)?
Travel planning: use Fairfield, Ohio as the reference point for LATONIA YVETTE CUSHINGBERRY (FNP), then confirm.
Can I trust this NPI listing for LATONIA YVETTE CUSHINGBERRY (FNP)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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