Individual provider Active NPI

Caroline A Spettel, MSN, NP-C

  • Nurse Practitioner
  • Beachwood, OH
National Provider Identifier
1144470998
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
10249 Issued in OH
Practice address
3700 Park East Dr Ste 450
Beachwood, OH 44122-4318
Phone
(866) 849-0692
Fax
(888) 973-8821
NPI assigned
Sep 29, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 10249 OH Primary
Adult Health Nurse Practitioner 363LA2200X APRN.CNP.10249 OH

Addresses

Primary practice location

3700 Park East Dr Ste 450
Beachwood, OH 44122-4318

Mailing address

PO Box 211699
Eagan, MN 55121-3699
Phone (866) 849-0692

Other practice location 1

280 Benedict Ave Ste A
Norwalk, OH 44857-2374
Phone (419) 668-8110

Other identifiers 1

IdentifierTypeStateIssuer
2937068MedicaidOH

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)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
10249OHMDNurse Practitioner
APRN.CNP.10249OHMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1222646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1144470998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 211699",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551213699",
            "telephone_number": "866-849-0692",
            "fax_number": "888-973-8821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 PARK EAST DR STE 450",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441224318",
            "telephone_number": "866-849-0692",
            "fax_number": "888-973-8821"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "280 Benedict Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Norwalk",
            "state": "OH",
            "postal_code": "448572374",
            "country_code": "US",
            "telephone_number": "419-668-8110",
            "fax_number": "419-660-6996",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPETTEL",
        "first_name": "CAROLINE",
        "middle_name": "A",
        "credential": "MSN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-29",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "10249",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "APRN.CNP.10249",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2937068",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; 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.