Individual provider Active NPI

Alla Khekhoyeva, NP

  • Nurse Practitioner
  • Cincinnati, OH
National Provider Identifier
1396178034
Registry record updated Aug 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
COA.14266-NP Issued in OH
Practice address
4623 Wesley Ave Ste P
Cincinnati, OH 45212-2272
Phone
(513) 841-0777
NPI assigned
Aug 16, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 14266 OH
Nurse Practitioner 363L00000X COA.14266-NP OH Primary

Addresses

Primary practice location

4623 Wesley Ave Ste P
Cincinnati, OH 45212-2272

Mailing address

PO Box 1239
Troy, MI 48099-1239

Other practice location 1

16600 W Sprague Rd Ste 120
Middleburg Heights, OH 44130-6300
Phone (440) 826-0500

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
I20140915000660 OH Practitioner - Nurse Practitioner 4789803313 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
COA.14266-NPOHMDNurse Practitioner
14266OHMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa PC CurrentSince Aug 11, 2014 Accepting new patients
Vpa PC CurrentSince Aug 11, 2014 Accepting new patients
Vpa PC Current Accepting new patients
Vpa PC Current Accepting new patients
Vpa PC Current Accepting new patients
Vpa PC Current Accepting new patients

Locations

4623 Wesley Ave
Ste P
Cincinnati, OH 45212
Phone (513) 841-0777

4435 Aicholtz Rd
Ste 400
Cincinnati, OH 45245
Phone (513) 326-3007

355 E Campus View Blvd
Ste 180
Columbus, OH 43235
Phone (614) 523-2155

3500 Massillon Rd
Ste 280
Green, OH 44685
Phone (330) 896-5651

7350 Industrial Park Blvd
Mentor, OH 44060
Phone (216) 732-9480

16600 W Sprague Rd
Ste 120
Middleburg Heights, OH 44130
Phone (440) 826-0500

3033 Kettering Blvd
Ste 100
Moraine, OH 45439
Phone (937) 293-2133

7206 Market St
Ste A
Youngstown, OH 44512
Phone (330) 726-3379

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1376611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629244800000",
    "number": "1396178034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1239",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480991239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4623 WESLEY AVE STE P",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452122272",
            "telephone_number": "513-841-0777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16600 W Sprague Rd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Middleburg Heights",
            "state": "OH",
            "postal_code": "441306300",
            "country_code": "US",
            "telephone_number": "440-826-0500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHEKHOYEVA",
        "first_name": "ALLA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-16",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "14266",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "COA.14266-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.