Individual provider Active NPI

Katherine Colleen Elliot, FNP

  • Primary Care Nurse Practitioner
  • Westerville, OH
National Provider Identifier
1073581674
Registry record updated Sep 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
APRN.CNP.08707 Issued in OH
Practice address
444 N Cleveland Ave Ste 120
Westerville, OH 43082-8388
Phone
(614) 818-0300
Fax
(614) 818-0313
NPI assigned
Mar 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X RN286863 OH
Primary Care Nurse Practitioner 363LP2300X APRN.CNP.08707 OH Primary

Addresses

Primary practice location

444 N Cleveland Ave Ste 120
Westerville, OH 43082-8388

Mailing address

444 N Cleveland Ave Ste 120
Westerville, OH 43082-8388
Phone (614) 818-0300

Other identifiers 1

IdentifierTypeStateIssuer
2630040MedicaidOH

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
I20060125000343 OH Practitioner - Nurse Practitioner 1850315177 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oh Independent Medical Group LLCGroup PAC ID 0648646034, 136 clinicians

Practice addresses (Care Compare)

444 N Cleveland Ave
Suite 120
Westerville, OH 43082-8388
Phone (614) 818-0300

Hospital & facility affiliations

  • Mount Carmel St Ann'S Hospital, Westerville, OH, CCN 360012

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN286863OHMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oh Independent Medical Group LLC CurrentSince Nov 4, 2023 Accepting new patients
Oh Independent Medical Group LLC CurrentSince Nov 4, 2023 Accepting new patients

Locations

7450 Hospital Dr
Ste 4500
Dublin, OH 43016
Phone (614) 566-0166

444 N Cleveland Ave
Ste 120
Westerville, OH 43082
Phone (614) 818-0300

Interoperability endpoints

  • Direct secure messaging: katherine.elliot.1@26020.direct.athenahealth.com
  • Direct secure messaging: katherine.elliot.1@33290.direct.athenahealth.com

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.

Hospital & facility affiliations 1

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": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1073581674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 N CLEVELAND AVE STE 120",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430828388",
            "telephone_number": "614-818-0300",
            "fax_number": "614-818-0313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 N CLEVELAND AVE STE 120",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430828388",
            "telephone_number": "614-818-0300",
            "fax_number": "614-818-0313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOT",
        "first_name": "KATHERINE",
        "middle_name": "COLLEEN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-09",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OH",
            "license": "RN286863",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OH",
            "license": "APRN.CNP.08707",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2630040",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westerville, OH

Sources for this page

Verify at the official NPI Registry.