Active NPI
Elizabeth A Colebank-Andes, AGACNP
- Adult Health Nurse Practitioner
- Beavercreek, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- APRN.CNP.024731
- Practice address
- 3535 Pentagon Blvd Ste 330
Beavercreek, OH 45431-1705 - Phone
- (937) 558-3021
- Fax
- (937) 558-3026
- NPI assigned
- Aug 21, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | 100789 | WV | |
| Adult Health Nurse Practitioner | 363LA2200X | APRN.CNP.024731 | OH | Primary |
Addresses
Primary practice location
3535 Pentagon Blvd Ste 330
Beavercreek, OH 45431-1705
Mailing address
1 Prestige PL Ste 550
Miamisburg, OH 45342-6115
Phone (937) 762-1310
Other practice location 1
1 Medical Center Dr
Morgantown, WV 26506-1200
Phone (877) 988-4478
Other practice location 2
1 Prestige Pl Ste 550
Miamisburg, OH 45342-6115
Phone (937) 762-1310
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ecolebankandes10859@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 WV, OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- University of Cincinnati College of Medicine, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2510 Commons Blvd
Suite 125
Beavercreek, OH 45431-3835
Phone (937) 454-9527
3535 Pentagon Blvd
Beavercreek, OH 45431-1705
3535 Pentagon Park Blvd
Suite 400
Dayton, OH 45431-1705
Phone (937) 490-2264
4403 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 433-5309
4441 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 298-7751
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.34 of 100
- Quality
- 63.67
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 74.14
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN.CNP.024731 | OH | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kettering Independent Medical Group Inc | Current | Accepting new patients |
Locations
3535 Pentagon Blvd
Ste 330
Beavercreek, OH 45431
Phone (937) 558-3021
4403 Far Hills Ave
Kettering, OH 45429
Phone (937) 395-3910
1 Prestige Pl
Ste 550
Miamisburg, OH 45342
Phone (937) 752-2306
2300 N Limestone St
Ste 120
Springfield, OH 45503
Phone (866) 224-9472
1141 N Monroe Dr
Fl 3
Xenia, OH 45385
Phone (937) 372-3638
Organizations & group practices 1
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.
-
- Orthopaedic Surgery Physician
- Miamisburg, OH
- NPI 1629387865
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Beavercreek, OH
- NPI 1760764849
-
- General Acute Care Hospital
- Dayton, OH
- NPI 1053339507
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731974400000",
"number": "1407336233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 PRESTIGE PL STE 550",
"city": "MIAMISBURG",
"state": "OH",
"postal_code": "453426115",
"telephone_number": "937-762-1310",
"fax_number": "937-522-8493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3535 PENTAGON BLVD STE 330",
"city": "BEAVERCREEK",
"state": "OH",
"postal_code": "454311705",
"telephone_number": "937-558-3021",
"fax_number": "937-558-3026"
}
],
"practiceLocations": [
{
"address_1": "1 Medical Center Dr",
"address_purpose": "LOCATION",
"city": "Morgantown",
"state": "WV",
"postal_code": "265061200",
"country_code": "US",
"telephone_number": "877-988-4478",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1 Prestige Pl Ste 550",
"address_purpose": "LOCATION",
"city": "Miamisburg",
"state": "OH",
"postal_code": "453426115",
"country_code": "US",
"telephone_number": "937-762-1310",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "COLEBANK-ANDES",
"first_name": "ELIZABETH",
"middle_name": "A",
"credential": "AGACNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-21",
"last_updated": "2024-11-19",
"certification_date": "2024-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "WV",
"license": "100789",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "OH",
"license": "APRN.CNP.024731",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ecolebankandes10859@direct.ketteringhealth.org",
"affiliation": "N",
"address_1": "3535 Pentagon Blvd Ste 330",
"city": "Beavercreek",
"state": "OH",
"country_code": "US",
"postal_code": "454311705",
"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": "3535 Pentagon Blvd Ste 330",
"city": "Beavercreek",
"state": "OH",
"country_code": "US",
"postal_code": "454311705",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Beavercreek, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; 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.