Individual provider Active NPI

Emily C. Ickes, APRN-CNP

  • Nurse Practitioner
  • Westerville, OH
National Provider Identifier
1295224970
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN.CNP.022833 Issued in OH
Practice address
6100 N Hamilton Rd
Westerville, OH 43081-2062
Phone
(614) 293-7500
Fax
(614) 685-9427
NPI assigned
May 8, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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 APRN.CNP.022833 OH
Nurse Practitioner 363L00000X APRN.CNP.022833 OH Primary

Addresses

Primary practice location

6100 N Hamilton Rd
Westerville, OH 43081-2062

Mailing address

700 Ackerman Rd Ste 2120
Columbus, OH 43202-1559
Phone (614) 293-7500

Other names 1

  • Emily Catherine Kundtz Former name

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
I20180730002975 OH Practitioner - Nurse Practitioner 5496003048 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
Telehealth
Offers telehealth services
Group practices
Osu General Internal Medicine LLCGroup PAC ID 7517103955, 270 clinicians

Practice addresses (Care Compare)

2050 Kenny Rd
Columbus, OH 43221-3502
Phone (614) 293-8054

6100 N Hamilton Rd
Westerville, OH 43081-2062
Phone (614) 814-8490

Hospital & facility affiliations

  • Ohio State University State Health System Hospital, Columbus, OH, CCN 360085
  • James Cancer Hospital & Solove Research Institute Hospital, Columbus, OH, CCN 360242

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
APRN.CNP.022833OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Osu General Internal Medicine LLC Nurse Practitioner CurrentSince Jul 1, 2022 Accepting new patients

Locations

543 Taylor Ave
Fl 2
Columbus, OH 43203
Phone (614) 293-2700

2050 Kenny Rd
Columbus, OH 43221
Phone (614) 293-8054

2231 N High St
Columbus, OH 43201
Phone (614) 293-2700

700 Ackerman Rd
Ste 570
Columbus, OH 43202
Phone (614) 293-2046

700 Ackerman Rd
Ste 2120
Columbus, OH 43202

410 W 10th Ave
Columbus, OH 43210
Phone (614) 293-5905

6100 N Hamilton Rd
Westerville, OH 43081
Phone (614) 814-8100

6100 N Hamilton Rd
Ste 3C
Westerville, OH 43081
Phone (614) 293-7500

Interoperability endpoints

  • Direct secure messaging: eickes43058@direct.osumc.edu

Organizations & group practices 1

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 4

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": "1525737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1295224970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 2120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "614-293-7500",
            "fax_number": "614-685-9427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 N HAMILTON RD",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430812062",
            "telephone_number": "614-293-7500",
            "fax_number": "614-685-9427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ICKES",
        "first_name": "EMILY",
        "middle_name": "C.",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-08",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.022833",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.022833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "KUNDTZ",
            "middle_name": "CATHERINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Westerville, OH

Sources for this page

Verify at the official NPI Registry.