Kaylynn M Pember, RN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

0029734 Issued in OH

Practice address

3593 Medina Rd # 181
Medina, OH 44256-8182

Phone

(330) 536-3746

Fax

(330) 267-4250

NPI assigned

Sep 15, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Alcove Ventures LLCGroup PAC ID 1456669605, 50 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wooster Community Hospital Hospital, Wooster, OH, CCN 360036
• Aultman Orrville Hospital Hospital, Orrville, OH, CCN 361323

Merit-based Incentive Payment System (MIPS)

Final score

98.06 of 100Reported as group

Quality

90.22

Promoting interoperability

100

Improvement activities

40

Cost

69.97

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alcove Ventures LLC

  dba Psych360

  • Psychiatric/Mental Health Nurse Practitioner
  • Cleveland, OH
  • NPI 1093191322
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• City of Wooster

  dba Wooster Community Hospital

  • General Acute Care Hospital
  • Wooster, OH
  • NPI 1437156247
  Care Compare affiliation
• Orrville Hospital Foundation

  dba Aultman Orrville Hospital

  • Critical Access Hospital
  • Orrville, OH
  • NPI 1891718375
  Care Compare affiliation

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

{
    "created_epoch": "1631664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1124798871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3593 MEDINA RD # 181",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442568182",
            "telephone_number": "330-536-3746",
            "fax_number": "330-267-4250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3593 MEDINA RD # 181",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442568182",
            "telephone_number": "330-536-3746",
            "fax_number": "330-267-4250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEMBER",
        "first_name": "KAYLYNN",
        "middle_name": "M",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-15",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "406459",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "0029734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Pearson
• Tiffany Peets, LPC
• Carol Ann Pelegrin, L.I.S.W.
• Jenna Ann Pelfrey
• Michael Patrick Pelini, PA-C
• Performance Therapy Group, Inc.
• Amber Perkins, PRS CDCA 699
• Tiffinne Perkins, NURSE PRACTITIONER
• Deborah Perry, RN
• Heather Anne Petek

• Psychiatric/Mental Health Nurse Practitioner in Medina, OH
• Providers in Medina, OH by specialty
• Psychiatric/Mental Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.