Zachary Charles Niese, RN, CNP
Individual provider Active NPI Family Nurse Practitioner · Pandora, OH
NPI 1063978690 · NPPES record last updated May 24, 2022
Key facts
- NPI
- 1063978690
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- APRN.CNP.024287 (OH)
- Practice address
- 2040 Road P
Pandora, OH 45877-9733 - Phone
- (419) 615-2983
- Fax
- (833) 629-0555
- NPI assigned
- Feb 19, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Urgent Care Specialists, LLC
Practice addresses (Care Compare)
6210 Brandt Pike
Suite 102
Huber Heights, OH 45424-4019
Phone (937) 236-8630
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190405002053 | OH | Practitioner - Nurse Practitioner | 0547501249 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN.CNP.024287 | OH | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lima Memorial Professional Corporation | Current |
Accepting new patients | |
| Hometown Urgent Care of Michigan, P.C. | Current |
Accepting new patients | |
| Lima Memorial Professional Corporation | Current |
Accepting new patients | |
| Hometown Urgent Care of Michigan, PC | Current |
Accepting new patients | |
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
Locations
520 W Lincoln Ave
Ste A
Ada, OH 45810
Phone (419) 634-2015
L3982
Columbus, OH 43260
6210 Brandt Pike
Ste 102
Huber Heights, OH 45424
Phone (937) 236-8630
6210 Brandt Pike
Huber Heights, OH 45424
Phone (937) 236-8630
1612 N Memorial Dr
Lancaster, OH 43130
Phone (740) 994-4110
1001 Bellefontaine Ave
Lima, OH 45804
Phone (419) 228-3335
1540 Michigan St
Sidney, OH 45365
Phone (937) 492-1961
2277 Michigan St
Sidney, OH 45365
Phone (937) 492-1961
1200 Vester Ave
Springfield, OH 45503
Phone (937) 342-9520
1301 W 1st St
Springfield, OH 45504
Phone (937) 271-0066
602 W Redskin Trl
Wapakoneta, OH 45895
Phone (419) 738-5151
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APRN.CNP.024287 | OH | Yes |
Addresses
Primary practice location
2040 Road P
Pandora, OH 45877-9733
Mailing address
16855 Road 5
Pandora, OH 45877-9755
Phone (419) 615-2983
Other practice location 1
520 W Lincoln Ave Ste A
Ada, OH 45810-9466
Phone (419) 634-2015
Other practice location 2
15054 E US Route 224
Findlay, OH 45840-9794
Phone (419) 427-3030
Other providers in Pandora, OH
- David D Houston
- Emily Marie Kempf
- Nicole Martin
- Steven K McCullough
- Amy Marie Myers
- Pandora Chiropractic, LLC
- Pandora Family Physicians, Inc.
- Pandora-Gilboa Local School District
- Jennifer Leigh Rasmussen
- Alexandra Katherine Shaffer
All providers in Pandora, OH · Family Nurse Practitioner in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 24, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.