Individual provider Active NPI

Katey Ann Liston, PA-C

  • Physician Assistant
  • Columbus, OH
National Provider Identifier
1144064668
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.008791RX Issued in OH
Practice address
3535 Olentangy River Rd
Columbus, OH 43214-3908
Phone
(614) 566-5000
NPI assigned
Jun 20, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 50.008791RX OH
Physician Assistant 363A00000X 50.008791RX OH Primary

Addresses

Primary practice location

3535 Olentangy River Rd
Columbus, OH 43214-3908

Mailing address

PO Box 7527
Dublin, OH 43017-0727

Other names 1

  • Katey Ann Depuy Former name

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
I20250530000957 OH Practitioner - Physician Assistant 2961911151 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohiohealth CorporationGroup PAC ID 6305758426, 2,295 clinicians

Practice addresses (Care Compare)

3535 Olentangy River Rd
Columbus, OH 43214-3908

393 E Town St
Columbus, OH 43215-4799

Hospital & facility affiliations

  • Riverside Methodist Hospital Hospital, Columbus, OH, CCN 360006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation CurrentSince Jun 1, 2025 Accepting new patients
Ohiohealth Corporation CurrentSince Jun 1, 2025 Accepting new patients

Locations

3535 Olentangy River Rd
Columbus, OH 43214
Phone (614) 566-1997

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

Dept L3652
Columbus, OH 43260

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": "1718841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1144064668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7527",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430170727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 OLENTANGY RIVER RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432143908",
            "telephone_number": "614-566-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISTON",
        "first_name": "KATEY",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-20",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": "50.008791RX",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.008791RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATEY",
            "last_name": "DEPUY",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.