Individual provider Active NPI

Habiba Audu, LPN

  • Psychiatric/Mental Health Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1356636328
Registry record updated Feb 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN.CNP.0033279 Issued in OH
Practice address
6161 Busch Blvd
Columbus, OH 43229-2508
Phone
(302) 229-2824
Fax
(614) 547-7992
NPI assigned
Jun 17, 2011
Last updated
Feb 23, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN.CNP.0033279 OH Primary
Licensed Practical Nurse 164W00000X L2-0010492 DE

Addresses

Primary practice location

6161 Busch Blvd
Columbus, OH 43229-2508

Mailing address

6161 Busch Blvd
Columbus, OH 43229-2508
Phone (302) 229-2824

Other practice location 1

6161 Busch Blvd Ste 32
Columbus, OH 43229-2508
Phone (302) 229-2824

Other identifiers 1

IdentifierTypeStateIssuer
MA7844182MedicaidOH

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
I20231214000477 OH Practitioner - Nurse Practitioner 1850687492 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Group practices
Mount Carmel Behavioral Healthcare LLCGroup PAC ID 0446595383, 11 clinicians

Practice addresses (Care Compare)

4646 Hilton Corporate Dr
Columbus, OH 43232-4147
Phone (614) 487-2020

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L2-0010492DEMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Carmel Behavioral Healthcare, LLC CurrentSince Oct 3, 2023 Accepting new patients
Alliance Express Home Care Services, LLC CurrentSince Dec 22, 2019 Accepting new patients

Locations

4646 Hilton Ln
Columbus, OH 43232
Phone (614) 487-2020

6161 Busch Blvd
Ste 82
Columbus, OH 43229
Phone (614) 547-7793

6100 Tower Cir
Ste 1000
Franklin, TN 37067
Phone (615) 454-7459

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1308268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1356636328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6161 BUSCH BLVD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432292508",
            "telephone_number": "302-229-2824",
            "fax_number": "614-547-7992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6161 BUSCH BLVD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432292508",
            "telephone_number": "302-229-2824",
            "fax_number": "614-547-7992"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6161 Busch Blvd Ste 32",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432292508",
            "country_code": "US",
            "telephone_number": "302-229-2824",
            "fax_number": "614-547-7992",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AUDU",
        "first_name": "HABIBA",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-17",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0033279",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "DE",
            "license": "L2-0010492",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MA7844182",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.