Individual provider Active NPI

Kelly Ratliff

  • Licensed Practical Nurse
  • West Chester, OH
National Provider Identifier
1104459247
Registry record updated Feb 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LPN.170853.MEDS-IV Issued in OH
Practice address
6942 Tylersville Rd
West Chester, OH 45069-1511
Phone
(513) 795-7557
Fax
(513) 737-4603
NPI assigned
Feb 18, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN.170853.MEDS-IV OH Primary

Addresses

Primary practice location

6942 Tylersville Rd
West Chester, OH 45069-1511

Mailing address

6942 Tylersville Rd
West Chester, OH 45069-1511
Phone (513) 795-7557

Other practice location 1

1910 Fairgrove Ave
Hamilton, OH 45011-1930
Phone (513) 795-7557

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

State licenses

LicenseStateTypeSpecialty
LPN.170853.MEDS-IVOHMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Modern Psychiatry & Wellness, LLC PastSince Nov 1, 2020 Accepting new patients
Modern Psychiatry and Wellness LLC PastSince Nov 26, 2012 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/5507/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.qualifacts.org/api/fhir/mpwhealth/r4/

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": "1581984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581984000000",
    "number": "1104459247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6942 TYLERSVILLE RD",
            "city": "WEST CHESTER",
            "state": "OH",
            "postal_code": "450691511",
            "telephone_number": "513-795-7557",
            "fax_number": "513-737-4603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6942 TYLERSVILLE RD",
            "city": "WEST CHESTER",
            "state": "OH",
            "postal_code": "450691511",
            "telephone_number": "513-795-7557",
            "fax_number": "513-737-4603"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1910 Fairgrove Ave",
            "address_purpose": "LOCATION",
            "city": "Hamilton",
            "state": "OH",
            "postal_code": "450111930",
            "country_code": "US",
            "telephone_number": "513-795-7557",
            "fax_number": "513-737-4603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RATLIFF",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-18",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "LPN.170853.MEDS-IV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Chester, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2020; 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.