Individual provider Active NPI

Chad Ashton Wolf

  • Family Nurse Practitioner
  • Mason, OH
National Provider Identifier
1205211661
Registry record updated Jul 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.17869 Issued in OH
Practice address
5100 Terra Firma Dr
Mason, OH 45040
Phone
(513) 492-5787
NPI assigned
Jul 28, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.17869 OH Primary

Addresses

Primary practice location

5100 Terra Firma Dr
Mason, OH 45040

Mailing address

2620 Elm Hill Pike
Nashville, TN 37214-3108
Phone (615) 425-4200

Other practice location 1

446 Morgan St
Cincinnati, OH 45206-2348
Phone (513) 834-7063

Other identifiers 1

IdentifierTypeStateIssuer
0143246MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20190909003628 KY Practitioner - Nurse Practitioner 1456668094 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
86.78 of 100Reported as group
Quality
71.59
Promoting interoperability
100
Improvement activities
40
Cost
84.34

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN.CNP.17869OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Little Clinic of Ohio LLC Family CurrentSince Aug 25, 2015 Accepting new patients
Kiosk Medicine Kentucky LLC Family CurrentSince Aug 2, 2019 Accepting new patients

Locations

2150 Dixie Hwy
Ft Mitchell, KY 41017
Phone (859) 292-1784

9080 Taylorsville Rd
Louisville, KY 40299
Phone (502) 491-8805

3039 Breckenridge Ln
Louisville, KY 40220
Phone (502) 451-4555

375 Cross Roads Blvd
Newport, KY 41076
Phone (859) 448-1170

199 Graceland Blvd
Columbus, OH 43214
Phone (614) 410-2814

5100 Terra Firma Dr
Mason, OH 45040
Phone (513) 229-5920

Interoperability endpoints

  • Direct secure messaging: chad.wolf@krogerhealth.eclinicaldirectplus.com

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": "1438041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530489600000",
    "number": "1205211661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 ELM HILL PIKE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372143108",
            "telephone_number": "615-425-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 TERRA FIRMA DR",
            "city": "MASON",
            "state": "OH",
            "postal_code": "45040",
            "telephone_number": "513-492-5787"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "446 Morgan St",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452062348",
            "country_code": "US",
            "telephone_number": "513-834-7063",
            "fax_number": "513-873-1567",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOLF",
        "first_name": "CHAD",
        "middle_name": "ASHTON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-28",
        "last_updated": "2018-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.17869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0143246",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mason, OH

Sources for this page

Verify at the official NPI Registry.