Individual provider Active NPI

Elise Stamper, APRN-CNP

  • Critical Care Medicine Nurse Practitioner
  • Dayton, OH
National Provider Identifier
1366102816
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Nurse PractitionerTaxonomy code 363LC0200X
License
APRN.CNP.0030599 Issued in OH
Practice address
1 Wyoming St
Dayton, OH 45409-2722
Phone
(937) 208-8000
NPI assigned
Dec 25, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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 402504 OH
Critical Care Medicine Nurse Practitioner 363LC0200X APRN.CNP.0030599 OH Primary

Addresses

Primary practice location

1 Wyoming St
Dayton, OH 45409-2722

Mailing address

1 Wyoming St
Dayton, OH 45409-2722
Phone (937) 503-6073

Other practice location 1

540 Lincoln Park Blvd Ste 200
Dayton, OH 45429-6403
Phone (937) 298-8058

Other practice location 2

540 Lincoln Park Blvd Ste 200
Dayton, OH 45429-6403
Phone (937) 298-8058

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address estamper571160@direct.ketteringhealth.org
FHIR URL https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/

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
I20220330000628 OH Practitioner - Nurse Practitioner 2769878826 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kettering Independent Medical Group IncGroup PAC ID 3173710936, 699 clinicians

Practice addresses (Care Compare)

540 Lincoln Park Blvd
Suite 200
Dayton, OH 45429-6403
Phone (937) 298-8058

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.38 of 100Reported as group
Quality
66.25
Promoting interoperability
100
Improvement activities
40
Cost
71.69

Merit-based Incentive Payment System (MIPS)

Final score
90.76 of 100Reported as group
Quality
96.83
Promoting interoperability
100
Improvement activities
40
Cost
72.38

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
402504OHMDRegistered Nurse
APRN.CNP.0030599OHMDCritical Care Medicine Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kettering Independent Medical Group Inc CurrentSince Feb 8, 2025 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

4403 Far Hills Ave
Kettering, OH 45429
Phone (937) 395-3910

4441 Far Hills Ave
Kettering, OH 45429
Phone (937) 298-7351

540 Lincoln Park Blvd
Ste 200
Kettering, OH 45429
Phone (937) 293-1117

1 Prestige Pl
Ste 550
Miamisburg, OH 45342
Phone (937) 752-2306

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1640390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1366102816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WYOMING ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454092722",
            "telephone_number": "937-503-6073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WYOMING ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454092722",
            "telephone_number": "937-208-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "540 Lincoln Park Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454296403",
            "country_code": "US",
            "telephone_number": "937-298-8058",
            "fax_number": "937-298-5638",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "540 Lincoln Park Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454296403",
            "country_code": "US",
            "telephone_number": "937-298-8058",
            "fax_number": "937-298-5638",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAMPER",
        "first_name": "ELISE",
        "credential": "APRN-CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-25",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "402504",
            "primary": false
        },
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "OH",
            "license": "APRN.CNP.0030599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "estamper571160@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "540 Lincoln Park Blvd Ste 200",
            "city": "Dayton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454296403",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "540 Lincoln Park Blvd Ste 200",
            "city": "Dayton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454296403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.