Individual provider Active NPI

Nicole M Demastry Kolikohn, FNP-BC

  • Family Nurse Practitioner
  • Nashville, TN
National Provider Identifier
1114517828
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.0027965 Issued in OH
Practice address
501 Great Circle Rd
Nashville, TN 37228-1317
Phone
(615) 436-9060
Fax
(615) 235-9725
NPI assigned
Jan 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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.0027965 OH Primary

Addresses

Primary practice location

501 Great Circle Rd
Nashville, TN 37228-1317

Mailing address

1897 Pleasantville Rd
Lancaster, OH 43130-9348
Phone (740) 503-5025

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
I20220825000757 OH Practitioner - Nurse Practitioner 3678957602 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Ohio State University College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

282 Sells Rd
Lancaster, OH 43130-3461
Phone (740) 654-7077

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0027965OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fairhope Hospice & Palliative Care Inc Family CurrentSince Jun 10, 2022 Accepting new patients
Fairhope Hospice & Palliative Care Inc PastSince Jun 10, 2022 Accepting new patients

Locations

1319 E Main St
Lancaster, OH 43130
Phone (740) 653-9411

282 Sells Rd
Lancaster, OH 43130
Phone (740) 654-7077

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.

Hospital & facility affiliations 1

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": "1611619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1114517828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1897 PLEASANTVILLE RD",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431309348",
            "telephone_number": "740-503-5025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 GREAT CIRCLE RD",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372281317",
            "telephone_number": "615-436-9060",
            "fax_number": "615-235-9725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMASTRY KOLIKOHN",
        "first_name": "NICOLE",
        "middle_name": "M",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-26",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0027965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.