Dezerie A Powell, ARNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

NP13748 Issued in OH

Practice address

3433 Agler Rd
Suite 2800
Columbus, OH 43219-3387

Phone

(614) 645-1600

Fax

(614) 645-1347

NPI assigned

Sep 21, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Dezerie A Smith Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

State licenses

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

{
    "created_epoch": "1316563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1174806699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3433 AGLER RD",
            "address_2": "SUITE 2300",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432193387",
            "telephone_number": "614-645-5500",
            "fax_number": "614-458-1849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3433 AGLER RD",
            "address_2": "SUITE 2800",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432193387",
            "telephone_number": "614-645-1600",
            "fax_number": "614-645-1347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "DEZERIE",
        "middle_name": "A",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-21",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OH",
            "license": "NP13748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0071297",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEDIATRIC NURSING CERTIFICATION BOARD",
            "identifier": "20111699",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEZERIE",
            "last_name": "SMITH",
            "middle_name": "A",
            "credential": "CNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Carol Powell, CDCA
• Daniel Russell Powell, O.D.
• Daphne Powell
• David M Powell, MD
• Deanna Powell, LSW
• J Joshua K Powell
• Jake Powell
• Jessica M Powell
• Jherah Siraaj Powell, DDS
• Keandre Powell

• Pediatric Nurse Practitioner in Columbus, OH
• Providers in Columbus, OH by specialty
• Pediatric Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.