Individual provider Active NPI

Kelly Waugh, R.N.

  • School Registered Nurse
  • Miamisburg, OH
National Provider Identifier
1083087480
Registry record updated Nov 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
RN.257587 Issued in OH
Practice address
540 Park Ave
Miamisburg, OH 45342-2854
Phone
(937) 866-3381
Fax
(937) 866-3536
NPI assigned
Nov 6, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X RN.257587 OH Primary

Addresses

Primary practice location

540 Park Ave
Miamisburg, OH 45342-2854

Mailing address

190 Colonel Dr
Carlisle, OH 45005-4297
Phone (937) 866-3381

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN.257587OHMDSchool Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Miamisburg City Schools Past Accepting new patients

Organizations & group practices 1

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": "1446768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446768000000",
    "number": "1083087480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 COLONEL DR",
            "city": "CARLISLE",
            "state": "OH",
            "postal_code": "450054297",
            "telephone_number": "937-866-3381",
            "fax_number": "937-866-3536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 PARK AVE",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453422854",
            "telephone_number": "937-866-3381",
            "fax_number": "937-866-3536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAUGH",
        "first_name": "KELLY",
        "name_prefix": "Mrs.",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-06",
        "last_updated": "2015-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "OH",
            "license": "RN.257587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miamisburg, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.