Individual provider Active NPI

Krystal Nicole Foley, PA-C

  • Physician Assistant
  • London, OH
National Provider Identifier
1063803013
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.004257 Issued in OH
Practice address
210 N Main St
London, OH 43140-1115
Phone
(740) 845-7700
Fax
(740) 845-7701
NPI assigned
Feb 12, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.004257 OH Primary

Addresses

Primary practice location

210 N Main St
London, OH 43140-1115

Mailing address

700 Ackerman Rd Ste 2120
Columbus, OH 43202-1559
Phone (740) 845-7700

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
I20150331000867 OH Practitioner - Physician Assistant 4486971595 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Union County Physician CorporationGroup PAC ID 1557419173, 105 clinicians

Practice addresses (Care Compare)

120 Colemans Crossing Blvd
Suite C
Marysville, OH 43040-7115
Phone (937) 578-4200

Hospital & facility affiliations

  • Madison Health Hospital, London, OH, CCN 360189
  • Mary Rutan Hospital Hospital, Bellefontaine, OH, CCN 360197

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50.004257OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Rutan Hospital CurrentSince Sep 1, 2025 Accepting new patients
Mary Rutan Hospital CurrentSince Sep 1, 2025 Accepting new patients
Mary Rutan Hospital Past Accepting new patients

Locations

205 E Palmer Rd
Bellefontaine, OH 43311
Phone (937) 592-4015

1134 N Main St
Ste 3100
Bellefontaine, OH 43311
Phone (937) 651-6441

120 W Main St
Russells Point, OH 43348
Phone (937) 843-2048

1880 E US Highway 36
Urbana, OH 43078
Phone (937) 484-3500

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1423699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1063803013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 2120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "740-845-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 N MAIN ST",
            "city": "LONDON",
            "state": "OH",
            "postal_code": "431401115",
            "telephone_number": "740-845-7700",
            "fax_number": "740-845-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOLEY",
        "first_name": "KRYSTAL",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-12",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.004257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in London, OH

Sources for this page

Verify at the official NPI Registry.