Individual provider Active NPI

Mercy Kanyongo

  • Family Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1174174627
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.025721 Issued in OH
Practice address
5156 E Main St
Columbus, OH 43213-2424
Phone
(614) 702-7655
Fax
(614) 706-1770
NPI assigned
Sep 26, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F09191550 OH
Family Nurse Practitioner 363LF0000X APRN.CNP.025721 OH Primary

Addresses

Primary practice location

5156 E Main St
Columbus, OH 43213-2424

Mailing address

5156 E Main St
Columbus, OH 43213-2424
Phone (614) 702-7655

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL none

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
I20201016001270 OH Practitioner - Nurse Practitioner 9436579240 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN.CNP.025721OHMDFamily Nurse Practitioner
F09191550OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dedicated Columbus Ohio, LLC CurrentSince Feb 1, 2025 Accepting new patients
Theoria Medical CurrentSince Jun 28, 2023 Accepting new patients

Locations

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763

2260 Morse Rd
Columbus, OH 43229
Phone (305) 831-4453

5156 E Main St
Columbus, OH 43213
Phone (614) 702-7655

1030 High St
Worthington, OH 43085
Phone (614) 876-7356

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.

NPI Registry JSON

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

{
    "created_epoch": "1569456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1174174627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5156 E MAIN ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432132424",
            "telephone_number": "614-702-7655",
            "fax_number": "614-706-1770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5156 E MAIN ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432132424",
            "telephone_number": "614-702-7655",
            "fax_number": "614-706-1770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANYONGO",
        "first_name": "MERCY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-26",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "F09191550",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.025721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "none",
            "affiliation": "N",
            "address_1": "6235 Solitare Ln",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432317621",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.