Individual provider Active NPI

Kelly L Nagel, FNP

  • Family Nurse Practitioner
  • Vandalia, OH
National Provider Identifier
1003927138
Registry record updated Jan 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
07533 Issued in OH
Practice address
505 Corporate Center Dr
Vandalia, OH 45377-1167
Phone
(937) 898-2097
NPI assigned
Aug 31, 2006
Last updated
Jan 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 07533 OH Primary

Addresses

Primary practice location

505 Corporate Center Dr
Vandalia, OH 45377-1167

Mailing address

505 Corporate Center Dr
Vandalia, OH 45377-1167
Phone (937) 898-2097

Other practice location 1

405 W Grand Ave
Dayton, OH 45405-7538
Phone (937) 723-3613

Other identifiers 1

IdentifierTypeStateIssuer
2479643MedicaidOH

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address knagel186119@direct.ketteringhealth.org
FHIR URL https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/

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
I20031125000938 OH Practitioner - Nurse Practitioner 7113821612 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Wright State University Boonshoft School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kettering Independent Medical Group IncGroup PAC ID 3173710936, 699 clinicians

Practice addresses (Care Compare)

4403 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 433-5309

4441 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 298-7751

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.34 of 100Reported as group
Quality
63.67
Promoting interoperability
100
Improvement activities
40
Cost
74.14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
07533OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kettering Independent Medical Group Inc CurrentSince Dec 29, 2022 Accepting new patients
Lima Memorial Professional Corporation Past Accepting new patients
Ekg Associates Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Lima Memorial Professional Corporation Past Accepting new patients
Mindgent Healthcare Clinics, LLC Past Accepting new patients

Locations

3535 Pentagon Blvd
Beavercreek, OH 45431
Phone (937) 702-4000

101 E Alex Bell Rd
Ste 190
Dayton, OH 45459
Phone (937) 425-4020

405 W Grand Ave
Dayton, OH 45405
Phone (937) 226-3200

405 W Grand Ave
Fl 4
Dayton, OH 45405
Phone (937) 558-3500

4403 Far Hills Ave
Kettering, OH 45429
Phone (937) 395-3910

1997 W Centerville Rd
Washington Township, OH 45459
Phone (937) 401-6000

Organizations & group practices 6

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 1

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1003927138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 CORPORATE CENTER DR",
            "city": "VANDALIA",
            "state": "OH",
            "postal_code": "453771167",
            "telephone_number": "937-898-2097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 CORPORATE CENTER DR",
            "city": "VANDALIA",
            "state": "OH",
            "postal_code": "453771167",
            "telephone_number": "937-898-2097"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "405 W Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454057538",
            "country_code": "US",
            "telephone_number": "937-723-3613",
            "fax_number": "937-723-3277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAGEL",
        "first_name": "KELLY",
        "middle_name": "L",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "07533",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2479643",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "knagel186119@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "405 W Grand Ave",
            "city": "Dayton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454057538",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "405 W Grand Ave",
            "city": "Dayton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454057538",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Vandalia, OH

Sources for this page

Verify at the official NPI Registry.