Individual provider Active NPI

Justin D Nolen, CNP

  • Nurse Practitioner
  • Lucasville, OH
National Provider Identifier
1366743569
Registry record updated Dec 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN.CNP.11904 Issued in OH
Practice address
10 Thomas Hollow Rd
Lucasville, OH 45648-8889
Phone
(740) 259-5699
Fax
(740) 259-2186
NPI assigned
Nov 4, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN.CNP.11904 OH Primary

Addresses

Primary practice location

10 Thomas Hollow Rd
Lucasville, OH 45648-8889

Mailing address

1735 27TH St Ste B06
Portsmouth, OH 45662-2681
Phone (740) 356-8681

Other identifiers 1

IdentifierTypeStateIssuer
3127495MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address justin.nolen@somc.medicity.net

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
I20110323001003 OH Practitioner - Nurse Practitioner 8022291301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Premier Therapy and Health Centers IncGroup PAC ID 7416859574, shared by 6 NPIs, 263 clinicians

Practice addresses (Care Compare)

10 Thomas Hollow Rd
Lucasville, OH 45648-8889
Phone (740) 259-5699

1248 Kinneys LN
Portsmouth, OH 45662-2927
Phone (740) 356-7290

1735 27TH St
Portsmouth, OH 45662-2679
Phone (740) 356-8822

1805 27TH St
Portsmouth, OH 45662-2640
Phone (740) 356-8117

7700 Ohio River Rd
Suite B
Wheelersburg, OH 45694-1653
Phone (740) 574-4616

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.59 of 100Reported as group
Quality
59.57
Promoting interoperability
100
Improvement activities
40
Cost
71.16

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Somc Medical Care Foundation, Inc. CurrentSince Sep 29, 2011 Accepting new patients
Somc Medical Care Foundation, Inc. Nurse Practitioner CurrentSince Sep 29, 2011 Accepting new patients

Locations

10 Thomas Hollow Rd
Lucasville, OH 45648
Phone (740) 259-5699

1735 27th St
Ste B06
Portsmouth, OH 45662
Phone (740) 356-7942

1735 27th St
Ste 302
Portsmouth, OH 45662
Phone (740) 355-8562

1805 27th St
Portsmouth, OH 45662
Phone (740) 356-5000

1735 27th St
Ste 204
Portsmouth, OH 45662
Phone (740) 355-8930

1248 Kinneys Ln
Portsmouth, OH 45662
Phone (740) 353-2131

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 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": "1288828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608163200000",
    "number": "1366743569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 27TH ST STE B06",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456622681",
            "telephone_number": "740-356-8681",
            "fax_number": "740-353-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 THOMAS HOLLOW RD",
            "city": "LUCASVILLE",
            "state": "OH",
            "postal_code": "456488889",
            "telephone_number": "740-259-5699",
            "fax_number": "740-259-2186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLEN",
        "first_name": "JUSTIN",
        "middle_name": "D",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-04",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.11904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3127495",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "justin.nolen@somc.medicity.net",
            "affiliation": "N",
            "address_1": "10 Thomas Hollow Rd",
            "city": "Lucasville",
            "state": "OH",
            "country_code": "US",
            "postal_code": "456488889",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lucasville, OH

Sources for this page

Verify at the official NPI Registry.