Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Ann C Basom, PMHNP

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1912630187

Ann C Basom, PMHNP is a Nurse Practitioner in Columbus, Ohio. Qualified in 2022, 4 years ago. Practices with Oh Independent Medical Group LLC, a 129-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Ohio.

Years since qualifying
4
Licensed in
OH
In the registry since
2022
What do these letters mean?
PMHNP — Psychiatric-Mental Health Nurse Practitioner
A nurse practitioner specialising in mental health, able to prescribe psychiatric medication.

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Practice location Address checks out

700 Childrens Dr
Columbus, OH 43205-2639
Phone: (614) 722-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4995 Bradenton Ave Ste 130, Dublin, OH 43017-3551 — (843) 475-8657

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence APRN.CNP.0032005 (OH)

Record details

NPI number1912630187
Entity typeIndividual (Type 1)
GenderFemale
Credentials PMHNP
Sole proprietorYes
NPI enumeratedJuly 6, 2022
Last updated in NPPESJune 11, 2025
Certification dateJune 11, 2025
Mailing address4995 Bradenton Ave, Dublin, OH 43017-3543

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Oh Independent Medical Group Llc — 129 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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