Individual provider Active NPI

Audrey Elizabeth Bateman, FNP

  • Family Nurse Practitioner
  • Vandalia, OH
National Provider Identifier
1114499894
Registry record updated Dec 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
LE-00026079 Issued in OH
Practice address
900 S Dixie Dr Ste 40
Vandalia, OH 45377-2656
Phone
(937) 890-6644
NPI assigned
Dec 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2018

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 LE-00026079 OH Primary

Addresses

Primary practice location

900 S Dixie Dr Ste 40
Vandalia, OH 45377-2656

Mailing address

640 E Cottage Ave
West Carrollton, OH 45449-1354
Phone (937) 371-4313

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
I20190205002965 OH Practitioner - Nurse Practitioner 4183962848 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Health Specialists IncGroup PAC ID 5597708594, 576 clinicians

Practice addresses (Care Compare)

1 Wyoming St
Dayton, OH 45409-2722

450 N Hyatt St
Suite 304
Tipp City, OH 45371-1433
Phone (937) 832-4773

600 Aviator CT
Suite 100
Vandalia, OH 45377-9464
Phone (937) 208-7776

680 Aviator CT
Vandalia, OH 45377-9464
Phone (937) 890-6644

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.38 of 100Reported as group
Quality
66.25
Promoting interoperability
100
Improvement activities
40
Cost
71.69

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LE-00026079OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Health Specialists Inc CurrentSince Feb 4, 2019 Accepting new patients
Premier Health Specialists Inc CurrentSince Feb 4, 2019 Accepting new patients
Premier Heart Associates, Inc Past Accepting new patients

Locations

1 Wyoming St
Ste 3100A
Dayton, OH 45409
Phone (937) 890-6644

30 E Apple St
#6258
Dayton, OH 45409
Phone (937) 208-5300

3170 Kettering Blvd
Fl Third
Moraine, OH 45439

101 Looney Rd
Piqua, OH 45356
Phone (937) 335-1660

450 N Hyatt St
Ste 304
Tipp City, OH 45371
Phone (937) 832-4773

900 S Dixie Dr
Ste 40
Vandalia, OH 45377
Phone (937) 890-6644

680 Aviator Ct
Vandalia, OH 45377
Phone (937) 890-6644

Organizations & group practices 3

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": "1545177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545177600000",
    "number": "1114499894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 E COTTAGE AVE",
            "city": "WEST CARROLLTON",
            "state": "OH",
            "postal_code": "454491354",
            "telephone_number": "937-371-4313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 S DIXIE DR STE 40",
            "city": "VANDALIA",
            "state": "OH",
            "postal_code": "453772656",
            "telephone_number": "937-890-6644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATEMAN",
        "first_name": "AUDREY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-19",
        "last_updated": "2018-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "LE-00026079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vandalia, OH

Sources for this page

Verify at the official NPI Registry.