Individual provider Active NPI

Kelsie N Malloy, APRN-CNP, PNP-AC

  • Pediatric Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1104660265
Registry record updated Aug 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
APRN.CNP.0036098 Issued in OH
Practice address
700 Childrens Dr
Columbus, OH 43205-2639
Phone
(614) 722-2000
NPI assigned
Jun 24, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X APRN.CNP.0036098 OH Primary
Acute Care Nurse Practitioner 363LA2100X APRN.CNP.0036098 OH

Addresses

Primary practice location

700 Childrens Dr
Columbus, OH 43205-2639

Mailing address

700 Childrens Dr
Columbus, OH 43205-2639
Phone (147) 222-0000

Other practice location 1

455 Executive Campus Dr
Westerville, OH 43082-8870
Phone (614) 722-2000

Other practice location 2

4363 All Seasons Dr Ste 100
Hilliard, OH 43026-2050
Phone (614) 722-2000

Other practice location 3

405 Butterfly Gardens Dr.
Columbus, OH 43215-3427
Phone (614) 722-2000

Other practice location 4

584 County Line Rd W
Westerville, OH 43082-7295
Phone (614) 722-2000

Other practice location 5

150 W Main St
New Albany, OH 43054-9229
Phone (614) 722-2000

Other practice location 6

536 S Trimble Rd
Mansfield, OH 44906-3418
Phone (614) 722-2000

Other practice location 7

5680 Venture Dr
Dublin, OH 43017-2190
Phone (614) 722-2000

Other practice location 8

6435 E Broad St
Columbus, OH 43213-1507
Phone (614) 722-2000

Other practice location 9

7901 Diley Rd Ste 150
Canal Winchester, OH 43110-9613
Phone (614) 722-2000

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
I20241202001415 OH Practitioner - Nurse Practitioner 5991230856 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Surgical Associates, Corporation Acute Care CurrentSince Sep 29, 2024 Accepting new patients

Locations

7901 Diley Rd
Ste 150
Canal Winchester, OH 43110
Phone (614) 355-9050

700 Childrens Dr
Columbus, OH 43205
Phone (614) 722-4411

6435 E Broad St
Columbus, OH 43213
Phone (614) 355-8100

479 Parsons Ave
Columbus, OH 43215
Phone (614) 272-8888

405 Butterfly Gardens Dr
Columbus, OH 43215
Phone (614) 722-4200

5680 Venture Dr
Dublin, OH 43017
Phone (614) 355-8700

4363 All Seasons Dr
Ste 100
Hilliard, OH 43026
Phone (614) 355-5900

536 S Trimble Rd
Mansfield, OH 44906
Phone (419) 528-3150

150 W Main St
New Albany, OH 43054
Phone (614) 355-6054

584 County Line Rd W
Westerville, OH 43082
Phone (614) 355-6052

455 Executive Campus Dr
Westerville, OH 43082
Phone (614) 355-6100

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": "1719187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786320000000",
    "number": "1104660265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 CHILDRENS DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052639",
            "telephone_number": "147-222-0000",
            "fax_number": "614-722-3454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 CHILDRENS DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052639",
            "telephone_number": "614-722-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "455 Executive Campus Dr",
            "address_purpose": "LOCATION",
            "city": "Westerville",
            "state": "OH",
            "postal_code": "430828870",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "fax_number": "614-722-3903",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4363 All Seasons Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Hilliard",
            "state": "OH",
            "postal_code": "430262050",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "fax_number": "614-722-3903",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "405 Butterfly Gardens Dr.",
            "address_purpose": "LOCATION",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432153427",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "fax_number": "614-722-3903",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "584 County Line Rd W",
            "address_purpose": "LOCATION",
            "city": "Westerville",
            "state": "OH",
            "postal_code": "430827295",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "fax_number": "614-722-3903",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "150 W Main St",
            "address_purpose": "LOCATION",
            "city": "New Albany",
            "state": "OH",
            "postal_code": "430549229",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "fax_number": "614-722-3903",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "536 S Trimble Rd",
            "address_purpose": "LOCATION",
            "city": "Mansfield",
            "state": "OH",
            "postal_code": "449063418",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "fax_number": "614-722-3903",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5680 Venture Dr",
            "address_purpose": "LOCATION",
            "city": "Dublin",
            "state": "OH",
            "postal_code": "430172190",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "fax_number": "614-722-3903",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6435 E Broad St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432131507",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "fax_number": "614-722-3903",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7901 Diley Rd Ste 150",
            "address_purpose": "LOCATION",
            "city": "Canal Winchester",
            "state": "OH",
            "postal_code": "431109613",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "fax_number": "614-722-3903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALLOY",
        "first_name": "KELSIE",
        "middle_name": "N",
        "credential": "APRN-CNP, PNP-AC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-24",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OH",
            "license": "APRN.CNP.0036098",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "APRN.CNP.0036098",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.