Individual provider Active NPI

Kesha Marie Nelson, PHD, MSN, APRN-CNP

  • Nurse Practitioner
  • Cincinnati, OH
National Provider Identifier
1104108331
Registry record updated May 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN.CNP.022645 Issued in OH
Practice address
3333 Burnet Avenue
ML 3014
Cincinnati, OH 45229-3026
Phone
(513) 636-4788
Fax
(513) 636-4283
NPI assigned
Sep 14, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN - 254785 OH
Registered Nurse 163W00000X 1127279 KY
Nurse Practitioner 363L00000X APRN.CNP.022645 OH Primary

Addresses

Primary practice location

3333 Burnet Avenue
ML 3014
Cincinnati, OH 45229-3026

Mailing address

3333 Burnet Avenue
ML 3014
Cincinnati, OH 45229-3026
Phone (513) 636-4788

Other practice location 1

Nunn Drive
NKU Dept of Nursing Albright Health Center Rm 335
Highland Heights, KY 41076-1559
Phone (859) 572-5554

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
I20180905001176 OH Practitioner - Nurse Practitioner 8921358474 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1127279KYMDRegistered Nurse
RN - 254785OHMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital Medical Center Nurse Practitioner CurrentSince Jul 23, 2018 Accepting new patients

Locations

3341 Solutions Ctr
Chicago, IL 60677

3333 Burnet Ave
#3014
Cincinnati, OH 45229
Phone (513) 636-4788

3333 Burnet Ave
#5021
Cincinnati, OH 45229
Phone (513) 636-4225

3333 Burnet Ave
Cincinnati, OH 45229
Phone (513) 636-4200

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": "1315958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525737600000",
    "number": "1104108331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVENUE",
            "address_2": "ML 3014",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293026",
            "telephone_number": "513-636-4788",
            "fax_number": "513-636-4283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVENUE",
            "address_2": "ML 3014",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293026",
            "telephone_number": "513-636-4788",
            "fax_number": "513-636-4283"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Nunn Drive",
            "address_2": "NKU Dept of Nursing Albright Health Center Rm 335",
            "address_purpose": "LOCATION",
            "city": "Highland Heights",
            "state": "KY",
            "postal_code": "410761559",
            "country_code": "US",
            "telephone_number": "859-572-5554",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "KESHA",
        "middle_name": "MARIE",
        "credential": "PHD,  MSN, APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-14",
        "last_updated": "2018-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN - 254785",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1127279",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.022645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.