Active NPI
Nicole Lynn Poellet, NP
- Nurse Practitioner
- Columbus, OH
National Provider Identifier
1376685628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 4704224225
- Practice address
- 1251 W Broad St
Columbus, OH 43222-1359 - Phone
- (614) 274-1455
- Fax
- (614) 274-1433
- NPI assigned
- Feb 13, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 4704224225 | MI | Primary |
Addresses
Primary practice location
1251 W Broad St
Columbus, OH 43222-1359
Mailing address
1251 W Broad St
700 KMS Place
Columbus, OH 43222-1359
Phone (614) 274-1455
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704224225 | MI | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469664000000",
"number": "1376685628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1251 W BROAD ST",
"address_2": "700 KMS PLACE",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432221359",
"telephone_number": "614-274-1455",
"fax_number": "614-274-1433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1251 W BROAD ST",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432221359",
"telephone_number": "614-274-1455",
"fax_number": "614-274-1433"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POELLET",
"first_name": "NICOLE",
"middle_name": "LYNN",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-13",
"last_updated": "2016-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MI",
"license": "4704224225",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.