Individual provider Active NPI

Keara Robertson

  • Family Nurse Practitioner
  • Berea, OH
National Provider Identifier
1417653841
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F02230254 Issued in OH
Practice address
205 W Bagley Rd
Berea, OH 44017-1886
Phone
(440) 298-8007
NPI assigned
Feb 7, 2023
Last updated
Feb 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F02230254 OH Primary

Addresses

Primary practice location

205 W Bagley Rd
Berea, OH 44017-1886

Mailing address

8206 Priem Rd
Strongsville, OH 44149-1105

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
I20230405002188 OH Practitioner - Nurse Practitioner 9537534581 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cleveland Surgical Associates, Inc.Group PAC ID 3577566371, 26 clinicians
Encore Clinical Services LLCGroup PAC ID 5991177313, 49 clinicians
Ohio Wound Care Associates LLCGroup PAC ID 7719393032, 17 clinicians

Practice addresses (Care Compare)

12301 Ridge Rd
North Royalton, OH 44133-3744
Phone (440) 652-8748

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F02230254OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Care Specialists, LLC CurrentSince Aug 28, 2025 Accepting new patients
Encore Clinical Services LLC Family CurrentSince Nov 11, 2024 Accepting new patients
Ohio Wound Care Associates LLC CurrentSince Nov 1, 2024 Accepting new patients
Lake Effect Health Current Accepting new patients
Hometown Urgent Care of Michigan, P.C. CurrentSince Mar 27, 2023 Accepting new patients
Cleveland Surgical Associates, Inc. CurrentSince Jul 9, 2023 Accepting new patients
Hometown Urgent Care of Michigan, PC CurrentSince Mar 27, 2023 Accepting new patients

Locations

2880 Stelzer Rd
Columbus, OH 43219
Phone (614) 472-2880

6210 Brandt Pike
Huber Heights, OH 45424
Phone (937) 236-8630

12301 Ridge Rd
North Royalton, OH 44133
Phone (216) 331-6750

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1675728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1417653841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8206 PRIEM RD",
            "city": "STRONGSVILLE",
            "state": "OH",
            "postal_code": "441491105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 W BAGLEY RD",
            "city": "BEREA",
            "state": "OH",
            "postal_code": "440171886",
            "telephone_number": "440-298-8007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "KEARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-07",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "F02230254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berea, OH

Sources for this page

Verify at the official NPI Registry.