Individual provider Active NPI

Nicole Hines, BSN, RN

  • Registered Nurse
  • Columbus, OH
National Provider Identifier
1114283116
Registry record updated Aug 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
425212 Issued in OH
Practice address
1374 E 22ND Ave
Columbus, OH 43211-2526
Phone
(614) 370-2564
NPI assigned
Apr 4, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 425212 OH
Licensed Practical Nurse 164W00000X 148567 OH
Registered Nurse 163W00000X 425212 OH Primary

Addresses

Primary practice location

1374 E 22ND Ave
Columbus, OH 43211-2526

Mailing address

1374 E 22ND Ave
Columbus, OH 43211-2526
Phone (614) 648-2406

Other identifiers 1

IdentifierTypeStateIssuer
2767242MedicaidOH

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
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
425212OHMDHome Health Registered Nurse
148567OHMDLicensed Practical Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1333497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1114283116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1374 E 22ND AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432112526",
            "telephone_number": "614-648-2406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1374 E 22ND AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432112526",
            "telephone_number": "614-370-2564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINES",
        "first_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "BSN, RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-04",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "OH",
            "license": "425212",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "148567",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "425212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2767242",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2021; 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.