Kelly J Slavik-Bosworth, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN.CNP.0028216 Issued in OH

Practice address

3700 Kolbe Rd
Lorain, OH 44053-1611

Phone

(440) 960-4416

Fax

(440) 960-4417

NPI assigned

Dec 29, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Health Physicians Lorain Specialty Care LLCGroup PAC ID 4688070055, 134 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Regional Medical Center Hospital, Lorain, OH, CCN 360172
• Mercy Allen Hospital Hospital, Oberlin, OH, CCN 361306

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

Practice roles

Locations

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: bslavik2314611@direct.bsmhealth.org
• Direct secure messaging: kslavikbosworth28095@ehrdirect.uhhospitals.org

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.

• Mercy Health Physicians Lorain Specialty Care LLC

  • Surgery Physician
  • Lorain, OH
  • NPI 1972126381

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Incare Health Solutions LLC

  • Internal Medicine Physician
  • Marion, OH
  • NPI 1235422403

  Multi-Specialty

  Medicare reassignment NPD
• Incare Health Solutions, LLC

  • Primary Care Nurse Practitioner
  • Ontario, OH
  • NPI 1639621824

  Multi-Specialty

  NPD
• Mercy Health Physicians Lorain Specialty Care LLC

  • Durable Medical Equipment & Medical Supplies
  • Vermilion, OH
  • NPI 1255063145
  NPD

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

• Mercy Health-Allen Hospital LLC

  • Critical Access Hospital
  • Oberlin, OH
  • NPI 1801825997
  Care Compare affiliation
• Mercy Health-Regional Medical Center LLC

  • Clinical Medical Laboratory
  • Lorain, OH
  • NPI 1164971800

  Hospital

  Care Compare affiliation
• Mercy Health-Regional Medical Center LLC

  • General Acute Care Hospital
  • Lorain, OH
  • NPI 1245274950
  Care Compare affiliation

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

{
    "created_epoch": "1609200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1366039935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 KOLBE RD",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440531611",
            "telephone_number": "440-960-4416",
            "fax_number": "440-960-4417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 KOLBE RD",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440531611",
            "telephone_number": "440-960-4416",
            "fax_number": "440-960-4417"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "36000 Detroit Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Avon",
            "state": "OH",
            "postal_code": "440111641",
            "country_code": "US",
            "telephone_number": "440-937-8074",
            "fax_number": "440-937-8725",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SLAVIK-BOSWORTH",
        "first_name": "KELLY",
        "middle_name": "J",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-29",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0028216",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0427883",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Sixbey, FNP
• Savannah Skelly, QMHS BA CM BA
• Matthew Scott Sklenka, LPC
• Charlene M Skorvanek, CNP
• Austin Floyd Slates, DPM
• Darrel Robert Smalls
• Sara Starr Smallwood
• Kassidy Smarsh
• Amber Smith, LISW-S
• Barbara Ann Smith, RN

• Family Nurse Practitioner in Lorain, OH
• Providers in Lorain, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.