Individual provider Active NPI

Nicole Stephens, CNP

  • Family Nurse Practitioner
  • Wapakoneta, OH
National Provider Identifier
1437870276
Registry record updated Sep 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0032285 Issued in OH
Practice address
1321 Bellefontaine St Ste 100
Wapakoneta, OH 45895-8769
Phone
(567) 356-4054
Fax
(567) 356-4056
NPI assigned
Sep 9, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X 0032285 OH Primary

Addresses

Primary practice location

1321 Bellefontaine St Ste 100
Wapakoneta, OH 45895-8769

Mailing address

1085 Polaris Pkwy
Columbus, OH 43240-2004
Phone (614) 505-0021

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
I20221028000895 OH Practitioner - Nurse Practitioner 3678940053 Reassigns benefits to 2 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

Practice addresses (Care Compare)

800 W Main St
Coldwater, OH 45828-1613
Phone (419) 678-2341

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0032285OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercer County Joint Township Community Hospital Multi-Specialty CurrentSince May 15, 2023 Accepting new patients
Incare Health Solutions LLC Multi-Specialty CurrentSince Jan 12, 2020 Accepting new patients
Incare Health Solutions, LLC Multi-Specialty CurrentSince Sep 8, 2022 Accepting new patients
Diagnostic Pathology, LLC Multi-Specialty Current Accepting new patients
Mercer County Joint Township Community Hospital CurrentSince May 15, 2023 Accepting new patients
Lima Memorial Joint Operating Company Multi-Specialty Past Accepting new patients
JTDM Family Practice LLC Multi-Specialty Past Accepting new patients

Locations

950 S Main St
Celina, OH 45822
Phone (419) 586-1611

800 W Main St
Coldwater, OH 45828
Phone (419) 678-2341

1085 Polaris Pkwy
Columbus, OH 43240
Phone (614) 505-0021

7450 State Route 161 E
Plain City, OH 43064
Phone (614) 504-5002

2562 W Market St
Tiffin, OH 44883
Phone (567) 938-8008

1321 Bellefontaine St
Ste 100
Wapakoneta, OH 45895
Phone (567) 356-4054

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1662681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662681600000",
    "number": "1437870276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1085 POLARIS PKWY",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432402004",
            "telephone_number": "614-505-0021",
            "fax_number": "614-505-0006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 BELLEFONTAINE ST STE 100",
            "city": "WAPAKONETA",
            "state": "OH",
            "postal_code": "458958769",
            "telephone_number": "567-356-4054",
            "fax_number": "567-356-4056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "NICOLE",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-09",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "0032285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wapakoneta, OH

Sources for this page

Verify at the official NPI Registry.