Individual provider Active NPI

Nicole Lynn McKee, CNP

  • Adult Health Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1023656642
Registry record updated Mar 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
025909 Issued in OH
Practice address
290 E Town St
Columbus, OH 43215-4602
Phone
(614) 788-5400
Fax
(614) 788-5500
NPI assigned
Dec 13, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 025909 OH
Adult Health Nurse Practitioner 363LA2200X 025909 OH Primary

Addresses

Primary practice location

290 E Town St
Columbus, OH 43215-4602

Mailing address

PO Box 7527
Dublin, OH 43017-0727
Phone (614) 788-5400

Other practice location 1

170 Bridge St
Jackson, OH 45640-1144
Phone (740) 577-3132

Other identifiers 1

IdentifierTypeStateIssuer
0402494MedicaidOH

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
I20200605001573 OH Practitioner - Nurse Practitioner 4284064601 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
025909OHMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation CurrentSince Sep 24, 2021 Accepting new patients
Ohiohealth Corporation CurrentSince Sep 24, 2021 Accepting new patients
Center for Symptom Relief LLC CurrentSince May 1, 2020 Accepting new patients
Shriver Family Practice LTD. PastSince Dec 1, 2019 Accepting new patients

Locations

1161 Bethel Rd
Unit 203204
Columbus, OH 43220
Phone (614) 450-0350

1161 Bethel Rd
Ste 203204
Columbus, OH 43220
Phone (614) 459-0350

Dept L3652
Columbus, OH 43260

290 E Town St
Columbus, OH 43215
Phone (614) 788-5400

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BFCJAA

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": "1576195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646092800000",
    "number": "1023656642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7527",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430170727",
            "telephone_number": "614-788-5400",
            "fax_number": "614-788-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 E TOWN ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432154602",
            "telephone_number": "614-788-5400",
            "fax_number": "614-788-5500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "170 Bridge St",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "OH",
            "postal_code": "456401144",
            "country_code": "US",
            "telephone_number": "740-577-3132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKEE",
        "first_name": "NICOLE",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-13",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OH",
            "license": "025909",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "025909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0402494",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.