Individual provider Active NPI

Katy Rieker, CNP

  • Nurse Practitioner
  • Mayfield Village, OH
National Provider Identifier
1306719570
Registry record updated May 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
OO37410 Issued in OH
Practice address
6559 Wilson Mills Rd Ste 106a
Mayfield Village, OH 44143-3433
Phone
(855) 449-1540
NPI assigned
Sep 24, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X OO37410 OH Primary
Gastroenterology Registered Nurse 163WG0100X 0037410 OH

Addresses

Primary practice location

6559 Wilson Mills Rd Ste 106a
Mayfield Village, OH 44143-3433

Mailing address

4952 Fairlawn Rd
Lyndhurst, OH 44124-1123

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
I20260528004052 OH Practitioner - Nurse Practitioner 6709356983 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4952 Fairlawn Rd
Lyndhurst, OH 44124-1123

6559 A Wilson Mills Rd
Suite 106
Mayfield Village, OH 44143-3433

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0037410OHMDGastroenterology Registered Nurse
OO37410OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mukunda Medical Group LLC Single Specialty Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1758672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778112000000",
    "number": "1306719570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4952 FAIRLAWN RD",
            "city": "LYNDHURST",
            "state": "OH",
            "postal_code": "441241123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6559 WILSON MILLS RD STE 106A",
            "city": "MAYFIELD VILLAGE",
            "state": "OH",
            "postal_code": "441433433",
            "telephone_number": "855-449-1540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIEKER",
        "first_name": "KATY",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-24",
        "last_updated": "2026-05-07",
        "certification_date": "2026-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "OO37410",
            "primary": true
        },
        {
            "code": "163WG0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gastroenterology",
            "state": "OH",
            "license": "0037410",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayfield Village, OH

Sources for this page

Verify at the official NPI Registry.