Individual provider Active NPI

Katherine Kowalak, CNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Cincinnati, OH
National Provider Identifier
1053028969
Registry record updated Oct 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN.CNP.0032555 Issued in OH
Practice address
6241 Berkinshaw Dr
Cincinnati, OH 45230-3663
Phone
(513) 708-7114
NPI assigned
Oct 31, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X E.0006818-SUPV OH
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN.CNP.0032555 OH Primary

Addresses

Primary practice location

6241 Berkinshaw Dr
Cincinnati, OH 45230-3663

Mailing address

6241 Berkinshaw Dr
Cincinnati, OH 45230-3663
Phone (513) 708-7114

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
I20230516000378 OH Practitioner - Nurse Practitioner 4385000462 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Woodstream WellnessGroup PAC ID 8527462506, 55 clinicians

Practice addresses (Care Compare)

9049 Springboro Pike
Miamisburg, OH 45342-4926
Phone (937) 759-0545

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E.0006818-SUPVOHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
WS Wellness LLC Mental Health CurrentSince Feb 1, 2023 Accepting new patients

Locations

1911 Old Fairfield Rd
Ste 310
Beavercreek, OH 45432
Phone (937) 759-0545

3330 Erie Ave
Ste 7
Cincinnati, OH 45208
Phone (937) 759-0545

9049 Springboro Pike
Ste A
Miamisburg, OH 45342
Phone (937) 759-0545

9049 Springboro Pike
Miamisburg, OH 45342
Phone (937) 759-0545

Organizations & group practices 2

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": "1667174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1053028969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6241 BERKINSHAW DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452303663",
            "telephone_number": "513-708-7114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6241 BERKINSHAW DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452303663",
            "telephone_number": "513-708-7114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWALAK",
        "first_name": "KATHERINE",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-31",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.0006818-SUPV",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0032555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.