NPIMap

Individual provider Active NPI

Kristine K Wickes

  • Nurse Practitioner
  • Gahanna, OH
National Provider Identifier
1316970007
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
07121 Issued in OH
Practice address
765 N Hamilton Rd
Suite 120
Gahanna, OH 43230-8703
Phone
(614) 337-9800
Fax
(614) 337-9591
NPI assigned
Jul 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 07121 OH Primary

Addresses

Primary practice location

765 N Hamilton Rd
Suite 120
Gahanna, OH 43230-8703

Mailing address

765 N Hamilton Rd
Suite 120
Gahanna, OH 43230-8703
Phone (614) 337-9800

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kwickes54682@direct.ohiohealth.com OhioHealth Physician Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051107000895 OH Practitioner - Nurse Practitioner 5092733154 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ohiohealth CorporationGroup PAC ID 6305758426, 2,295 clinicians

Practice addresses (Care Compare)

6024 Hoover Rd G
Grove City, OH 43123-8133
Phone (614) 566-7444

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.04 of 100Reported as group
Quality
58.67
Promoting interoperability
98
Improvement activities
40
Cost
76.46

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
07121OHMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation CurrentSince Nov 1, 2009 Accepting new patients
Ohiohealth Corporation CurrentSince Nov 1, 2009 Accepting new patients
Heartcare, Inc. Past Accepting new patients

Locations

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

Dept L3652
Columbus, OH 43260

551 W Central Ave
Ste 204
Delaware, OH 43015
Phone (740) 368-5077

5350 Frantz Rd
Dublin, OH 43016

765 N Hamilton Rd
Ste 120
Gahanna, OH 43230

765 N Hamilton Rd
Ste 260
Gahanna, OH 43230
Phone (614) 469-7621

6024 Hoover Rd
Ste G
Grove City, OH 43123
Phone (614) 324-9090

1325 Stringtown Rd
Ste 240
Grove City, OH 43123
Phone (614) 788-0130

Organizations & group practices 3

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 8

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": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1316970007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 N HAMILTON RD",
            "address_2": "SUITE 120",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432308703",
            "telephone_number": "614-337-9800",
            "fax_number": "614-337-9591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 N HAMILTON RD",
            "address_2": "SUITE 120",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432308703",
            "telephone_number": "614-337-9800",
            "fax_number": "614-337-9591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKES",
        "first_name": "KRISTINE",
        "middle_name": "K",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-08",
        "last_updated": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "07121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kwickes54682@direct.ohiohealth.com",
            "affiliation": "Y",
            "affiliationName": "OhioHealth Physician Group",
            "address_1": "765 N Hamilton Rd",
            "address_2": "Ste 120",
            "city": "Gahanna",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432308703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gahanna, OH

Sources for this page

Verify at the official NPI Registry.