Individual provider Active NPI

Collette M Neal, FNP-C

  • Family Nurse Practitioner
  • Marysville, OH
National Provider Identifier
1356193387
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.0036110 Issued in OH
Practice address
1501 W 5TH St
Marysville, OH 43040-9290
Phone
(937) 209-2454
NPI assigned
Apr 3, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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.0036110 OH Primary

Addresses

Primary practice location

1501 W 5TH St
Marysville, OH 43040-9290

Mailing address

PO Box 932958
Cleveland, OH 44193-0028

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
I20240423002834 OH Practitioner - Nurse Practitioner 2567801590 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Marion Pain Center, LLCGroup PAC ID 8224166996, 4 clinicians

Practice addresses (Care Compare)

1065 Delaware Ave
Suite a
Marion, OH 43302-6415
Phone (740) 387-7246

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0036110OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Little Clinic of Ohio LLC Family CurrentSince May 6, 2024 Accepting new patients
Marion Pain Center, LLC CurrentSince Dec 1, 2024 Accepting new patients
Marion Pain Center, LLC CurrentSince Dec 1, 2024 Accepting new patients
Theoria Medical CurrentSince Dec 29, 2024 Accepting new patients
Complexcare Medical Group Midwest M PLLC CurrentSince Jun 9, 2025 Accepting new patients
BKC Pain Specialists, LLC Past Accepting new patients

Locations

41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763

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

5700 Karl Rd
Columbus, OH 43229
Phone (614) 846-5420

1065 Delaware Ave
Ste A
Marion, OH 43302
Phone (614) 568-4646

1501 W 5th St
Marysville, OH 43040
Phone (937) 209-2454

1600 Saint Paris Pike
Springfield, OH 45504
Phone (937) 399-8131

7120 Port Sylvania Dr
Toledo, OH 43617
Phone (419) 841-2200

1030 High St
Worthington, OH 43085
Phone (614) 876-7356

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 6

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": "1712102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1356193387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 932958",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 W 5TH ST",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "430409290",
            "telephone_number": "937-209-2454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEAL",
        "first_name": "COLLETTE",
        "middle_name": "M",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-03",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0036110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marysville, OH

Sources for this page

Verify at the official NPI Registry.