Individual provider Active NPI

Nicole Dunwald, APRN-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Oregon, OH
National Provider Identifier
1164024121
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN.CNP.0028010 Issued in OH
Practice address
2600 Navarre Ave
Oregon, OH 43616-3207
Phone
(419) 696-8800
NPI assigned
Nov 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN.CNP.0028010 OH Primary

Addresses

Primary practice location

2600 Navarre Ave
Oregon, OH 43616-3207

Mailing address

3008 Strauss Ave
Toledo, OH 43606-2754
Phone (419) 450-7228

Other identifiers 1

IdentifierTypeStateIssuer
149-779-2568MedicaidOH

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
I20201203002652 OH Practitioner - Nurse Practitioner 1557772050 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Physicians North Specialty Care LLCGroup PAC ID 1951707884, 345 clinicians

Practice addresses (Care Compare)

2213 Cherry St
Toledo, OH 43608-2603

2600 Navarre Ave
Oregon, OH 43616-3207
Phone (419) 696-8877

3900 Sunforest CT
Suite 240
Toledo, OH 43623-4481
Phone (419) 475-1600

Hospital & facility affiliations

  • Mercy St Vincent Medical Center Hospital, Toledo, OH, CCN 360112

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians North Specialty Care LLC CurrentSince Sep 1, 2021 Accepting new patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Feb 6, 2026 Accepting new patients
Mercy Health Physicians North Specialty Care LLC Nurse Practitioner CurrentSince Sep 1, 2021 Accepting new patients

Locations

2600 Navarre Ave
Oregon, OH 43616
Phone (419) 696-7200

2222 Cherry St
Ste 2300
Toledo, OH 43608
Phone (419) 251-8013

2200 Jefferson Ave
Fl 5
Toledo, OH 43604
Phone (419) 251-9826

3900 Sunforest Ct
Ste 240
Toledo, OH 43623
Phone (419) 472-3126

Interoperability endpoints

  • Direct secure messaging: ndunwald835425@direct.bsmhealth.org

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 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": "1605225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1164024121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3008 STRAUSS AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436062754",
            "telephone_number": "419-450-7228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 NAVARRE AVE",
            "city": "OREGON",
            "state": "OH",
            "postal_code": "436163207",
            "telephone_number": "419-696-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNWALD",
        "first_name": "NICOLE",
        "credential": "APRN-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-13",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0028010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149-779-2568",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oregon, OH

Sources for this page

Verify at the official NPI Registry.