Individual provider Active NPI

Michelle Diederich, CNP

  • Acute Care Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1356659213
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
NP11900 Issued in OH
Practice address
111 S Grant Ave
Columbus, OH 43215-4701
Phone
(614) 566-8648
Fax
(614) 566-8825
NPI assigned
Sep 14, 2010
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN307507 OH
Acute Care Nurse Practitioner 363LA2100X NP11900 OH Primary

Addresses

Primary practice location

111 S Grant Ave
Columbus, OH 43215-4701

Mailing address

5450 Frantz Rd Ste 360
Dublin, OH 43016-4141
Phone (614) 544-6366

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mdiederich14571@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: 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
I20101208001151 OH Practitioner - Nurse Practitioner 6507053121 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohiohealth CorporationGroup PAC ID 6305758426, 2,295 clinicians

Practice addresses (Care Compare)

111 S Grant Ave
Columbus, OH 43215-4701
Phone (614) 566-9489

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
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN307507OHMDRegistered Nurse
NP11900OHMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation CurrentSince Oct 7, 2010 Accepting new patients
Marion Area Physicians LLC CurrentSince Sep 1, 2023 Accepting new patients
Ohiohealth Corporation Current Accepting new patients
Ohiohealth Corporation CurrentSince Oct 7, 2010 Accepting new patients

Locations

Dept L3652
Columbus, OH 43260

111 S Grant Ave
Columbus, OH 43215
Phone (614) 461-3232

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

3535 Olentangy River Rd
Columbus, OH 43214
Phone (614) 566-1997

5450 Frantz Rd
Ste 360
Dublin, OH 43016
Phone (614) 533-6497

335 Glessner Ave
Mansfield, OH 44903
Phone (419) 522-0320

1040 Delaware Ave
Marion, OH 43302
Phone (330) 256-9874

1000 McKinley Park Dr
Marion, OH 43302
Phone (740) 383-8400

500 London Ave
Marysville, OH 43040
Phone (740) 420-8451

45 St Lawrence Dr
Tiffin, OH 44883
Phone (419) 448-1900

Organizations & group practices 4

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 2

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": "1284422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1356659213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 FRANTZ RD STE 360",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430164141",
            "telephone_number": "614-544-6366",
            "fax_number": "614-544-6350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S GRANT AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432154701",
            "telephone_number": "614-566-8648",
            "fax_number": "614-566-8825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEDERICH",
        "first_name": "MICHELLE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-14",
        "last_updated": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN307507",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "NP11900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdiederich14571@direct.ohiohealth.com",
            "affiliation": "Y",
            "affiliationName": "OhioHealth Physician Group",
            "address_1": "3535 Olentangy River Rd",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432143908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.