Individual provider Active NPI

Elise Coudriet

  • Acute Care Nurse Practitioner
  • Canton, OH
National Provider Identifier
1235608209
Registry record updated Nov 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
APRN.CNP.023912 Issued in OH
Practice address
2600 6TH St SW
Canton, OH 44710-1799
Phone
(330) 363-9971
NPI assigned
Nov 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X APRN.CNP.023912 OH Primary

Addresses

Primary practice location

2600 6TH St SW
Canton, OH 44710-1799

Mailing address

2600 6TH St SW
Canton, OH 44710-1799
Phone (330) 363-9971

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
I20200521000810 OH Practitioner - Nurse Practitioner 3274964556 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aultman HospitalGroup PAC ID 3779485867, 41 clinicians

Practice addresses (Care Compare)

2600 6TH St SW
Canton, OH 44710-1702
Phone (330) 452-9911

2600 6TH St SW
Canton, OH 44710-1799

Hospital & facility affiliations

  • Aultman Hospital Hospital, Canton, OH, CCN 360084

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CNP.023912OHMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aultman Hospital CurrentSince Mar 1, 2020 Accepting new patients
Aultman Hospital CurrentSince Mar 1, 2020 Accepting new patients
Aultman Hospital Current Accepting new patients

Locations

2600 6th St SW
Canton, OH 44710
Phone (330) 363-2180

Organizations & group practices 8

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": "1542585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542585600000",
    "number": "1235608209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 6TH ST SW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447101799",
            "telephone_number": "330-363-9971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 6TH ST SW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447101799",
            "telephone_number": "330-363-9971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUDRIET",
        "first_name": "ELISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-19",
        "last_updated": "2018-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "APRN.CNP.023912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.