Individual provider Active NPI

Miriam Edith Kurtz Pumpelly

  • Family Nurse Practitioner
  • Upper Arlington, OH
National Provider Identifier
1083626972
Registry record updated Jun 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP.022031 Issued in OH
Practice address
1670 Fishinger Rd Ste 100
Upper Arlington, OH 43221-1420
Phone
(614) 450-0077
Fax
(509) 459-3355
NPI assigned
Aug 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 311030 OH
Registered Nurse 163W00000X RN00166818 WA
Family Nurse Practitioner 363LF0000X PENDING WA
Family Nurse Practitioner 363LF0000X CNP.022031 OH Primary

Addresses

Primary practice location

1670 Fishinger Rd Ste 100
Upper Arlington, OH 43221-1420

Mailing address

1670 Fishinger Rd Ste 100
Upper Arlington, OH 43221-1420
Phone (614) 450-0077

Other names 1

  • Miriam Edith Kurtz Rasmussen Former name

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
I20220826000687 OH Practitioner - Nurse Practitioner 2062418296 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PENDINGWAMDDentist
311030OHMDRegistered Nurse
RN00166818WAMDRegistered Nurse
CNP.022031OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Ohio Primary Care Physicians, Inc. CurrentSince Jul 1, 2022 Accepting new patients
Central Ohio Primary Care Physicians, Inc. Family CurrentSince Jul 1, 2022 Accepting new patients

Locations

4885 Olentangy River Rd
Columbus, OH 43214
Phone (614) 326-5665

1670 Fishinger Rd
Ste 100
Upper Arlington, OH 43221
Phone (614) 459-0077

655 Africa Rd
Westerville, OH 43082

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": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654992000000",
    "number": "1083626972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1670 FISHINGER RD STE 100",
            "city": "UPPER ARLINGTON",
            "state": "OH",
            "postal_code": "432211420",
            "telephone_number": "614-450-0077",
            "fax_number": "509-459-3355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1670 FISHINGER RD STE 100",
            "city": "UPPER ARLINGTON",
            "state": "OH",
            "postal_code": "432211420",
            "telephone_number": "614-450-0077",
            "fax_number": "509-459-3355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUMPELLY",
        "first_name": "MIRIAM",
        "middle_name": "EDITH KURTZ",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-12",
        "last_updated": "2022-06-12",
        "certification_date": "2022-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "311030",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN00166818",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "PENDING",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "CNP.022031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIRIAM",
            "last_name": "RASMUSSEN",
            "middle_name": "EDITH KURTZ",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Upper Arlington, OH

Sources for this page

Verify at the official NPI Registry.