Individual provider Active NPI

Traci A Powell, NP

  • Nurse Practitioner
  • Chillicothe, OH
National Provider Identifier
1013149939
Registry record updated Dec 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
312729 Issued in OH
Practice address
4439 State Route 159 Ste 150
Chillicothe, OH 45601-7833
Phone
(740) 779-8728
Fax
(740) 775-7855
NPI assigned
Aug 11, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 312729 OH Primary

Addresses

Primary practice location

4439 State Route 159 Ste 150
Chillicothe, OH 45601-7833

Mailing address

PO Box 188
1049 Western Avenue
Chillicothe, OH 45601-0188
Phone (740) 773-4366

Other identifiers 1

IdentifierTypeStateIssuer
3016042MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address adena.kidney@adena.medicity.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
312729OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Adena Medical Group LLC CurrentSince Mar 1, 2014 Accepting new patients
SNF Wound Care CurrentSince May 1, 2022 Accepting new patients
Hocking Emergency Physicians Inc Past Accepting new patients
University Medical Associates Inc. Past Accepting new patients

Locations

75 Kimes Ln
Athens, OH 45701
Phone (740) 593-3391

4439 State Route 159
Ste 150
Chillicothe, OH 45601
Phone (740) 779-4700

100 Dawn Ln
Waverly, OH 45690
Phone (740) 947-2186

12340 State Route 104
Waverly, OH 45690
Phone (740) 941-5180

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1249948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1013149939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 188",
            "address_2": "1049 WESTERN AVENUE",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456010188",
            "telephone_number": "740-773-4366",
            "fax_number": "740-775-7855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4439 STATE ROUTE 159 STE 150",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456017833",
            "telephone_number": "740-779-8728",
            "fax_number": "740-775-7855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "TRACI",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-11",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "312729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3016042",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adena.kidney@adena.medicity.net",
            "affiliation": "N",
            "address_1": "4439 State Route 159 Ste 150",
            "city": "Chillicothe",
            "state": "OH",
            "country_code": "US",
            "postal_code": "456017833",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chillicothe, OH

Sources for this page

Verify at the official NPI Registry.