Individual provider Active NPI

Vasty Klutse, DNP, NP-C

  • Family Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1104211937
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.17118 Issued in OH
Practice address
6011 Cleveland Ave Ste B
Columbus, OH 43231-2256
Phone
(614) 966-1690
Fax
(614) 368-0448
NPI assigned
Mar 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.17118 OH Primary

Addresses

Primary practice location

6011 Cleveland Ave Ste B
Columbus, OH 43231-2256

Mailing address

6011 Cleveland Ave Ste B
Columbus, OH 43231-2256
Phone (614) 966-1690

Other identifiers 1

IdentifierTypeStateIssuer
0137226MedicaidOH

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
I20150728004959 OH Practitioner - Nurse Practitioner 7911211412 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kuinmed, LLCGroup PAC ID 3870821036, 3 clinicians

Practice addresses (Care Compare)

6011 Cleveland Ave
Suite B
Columbus, OH 43231-2256
Phone (614) 966-1690

Hospital & facility affiliations

  • Grant Medical Center Hospital, Columbus, OH, CCN 360017
  • Mount Carmel St Ann'S Hospital, Westerville, OH, CCN 360012

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CNP.17118OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kuinmed LLC Family CurrentSince Feb 13, 2016 Accepting new patients
Health Resolution LLC CurrentSince Jul 2, 2023 Accepting new patients
Regional Healthcare Group LLC CurrentSince Sep 1, 2024 Accepting new patients
Guardian Biologics LLC CurrentSince Sep 3, 2024 Accepting new patients
Mobile Wound Care Solutions LLC CurrentSince Feb 1, 2025 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

6011 Cleveland Ave
#B
Columbus, OH 43231
Phone (614) 254-2543

920 W Market St
Ste 101
Lima, OH 45805
Phone (419) 229-3362

Organizations & group practices 6

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 2

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": "1427673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1104211937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6011 CLEVELAND AVE STE B",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432312256",
            "telephone_number": "614-966-1690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6011 CLEVELAND AVE STE B",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432312256",
            "telephone_number": "614-966-1690",
            "fax_number": "614-368-0448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUTSE",
        "first_name": "VASTY",
        "name_prefix": "Ms.",
        "credential": "DNP,  NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-30",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.17118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0137226",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.