NPIMap

Individual provider Active NPI

Kaitlyn Wattley, CNP

  • Family Nurse Practitioner
  • Hudson, OH
National Provider Identifier
1356714067
Registry record updated Jul 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.18327 Issued in OH
Practice address
1310 Corporate Dr
Hudson, OH 44236-4430
Phone
(330) 475-1631
Fax
(330) 475-1634
NPI assigned
Nov 3, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2021

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.18327 OH Primary

Addresses

Primary practice location

1310 Corporate Dr
Hudson, OH 44236-4430

Mailing address

3975 Embassy Pkwy
Akron, OH 44333-8320
Phone (330) 668-4040

Other names 1

  • Kaitlyn Murphy Former name

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
I20151201001714 OH Practitioner - Nurse Practitioner 1557661378 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crystal Clinic, Inc.Group PAC ID 7214821586, 46 clinicians
Sports and Orthopedic Rehabilitation Services IncGroup PAC ID 0840104253, shared by 4 NPIs, 314 clinicians

Practice addresses (Care Compare)

3975 Embassy Pkwy
Suite 102
Akron, OH 44333-1763
Phone (330) 668-4040

5347 Main St
Suite 202
New Port Richey, FL 34652-2520
Phone (727) 841-0515

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.83 of 100Reported as group
Quality
83.94
Promoting interoperability
100
Improvement activities
40
Cost
78.82

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CNP.18327OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Crystal Clinic Inc CurrentSince Dec 1, 2015 Accepting new patients
Crystal Clinic, Inc. CurrentSince Dec 1, 2015 Accepting new patients
Crystal Clinic Orthopaedic Center LLC CurrentSince Sep 1, 2018 Accepting new patients
Crystal Clinic Orthopaedic Center LLC CurrentSince Sep 1, 2018 Accepting new patients
Crystal Clinic Orthopaedic Center, LLC Past Accepting new patients

Locations

3975 Embassy Pkwy
Ste 202
Akron, OH 44333
Phone (330) 668-4085

3975 Embassy Pkwy
Akron, OH 44333
Phone (330) 670-4242

4466 Fulton Dr NW
Canton, OH 44718
Phone (330) 489-1386

437 Portage Trl
Cuyahoga Fls, OH 44221
Phone (330) 929-9136

3557 Embassy Pkwy
Fairlawn, OH 44333
Phone (330) 670-1005

3975 Embassy Pkwy
Ste 102
Fairlawn, OH 44333
Phone (330) 668-4050

1622 E Turkeyfoot Lake Rd
Ste 200
Green, OH 44312
Phone (330) 644-7436

1622 E Turkeyfoot Lake Rd
Ste 201
Green, OH 44312
Phone (330) 776-4440

1310 Corporate Dr
Hudson, OH 44236
Phone (330) 344-3030

4975 Foote Rd
Ste 100
Medina, OH 44256

Organizations & group practices 5

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 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1446508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1356714067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3975 EMBASSY PKWY",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443338320",
            "telephone_number": "330-668-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 CORPORATE DR",
            "city": "HUDSON",
            "state": "OH",
            "postal_code": "442364430",
            "telephone_number": "330-475-1631",
            "fax_number": "330-475-1634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTLEY",
        "first_name": "KAITLYN",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-03",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.18327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLYN",
            "last_name": "MURPHY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hudson, OH

Sources for this page

Verify at the official NPI Registry.