Individual provider Active NPI

Kimberly J Greene, NP

  • Family Nurse Practitioner
  • Westerville, OH
National Provider Identifier
1467542662
Registry record updated Jul 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.08946 Issued in OH
Practice address
625 Africa Rd Ste 200
Westerville, OH 43082
Phone
(614) 891-8080
Fax
(614) 891-7078
NPI assigned
Oct 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2018

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 APRN.CNP.08946 OH Primary

Addresses

Primary practice location

625 Africa Rd Ste 200
Westerville, OH 43082

Mailing address

625 Africa Rd Ste 200
Westerville, OH 43082-9808
Phone (614) 891-8080

Other identifiers 1

IdentifierTypeStateIssuer
2702141MedicaidOH

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
I20061026000371 OH Practitioner - Nurse Practitioner 4385641927 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CNP.08946OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Ohio Primary Care Physicians, Inc. CurrentSince Jul 1, 2013 Accepting new patients
Central Ohio Primary Care Physicians, Inc. Family CurrentSince Jul 1, 2013 Accepting new patients
Mount Carmel Health Past Accepting new patients
Lower Lights Christian Health Center, Inc. Past Accepting new patients

Locations

777 W State St
Ste 201
Columbus, OH 43222
Phone 6142741455313

4885 Olentangy River Rd
Columbus, OH 43214
Phone (614) 326-5665

535 Officenter Pl
Ste A
Gahanna, OH 43230
Phone (614) 471-9654

291 W Schrock Rd
Ste B
Westerville, OH 43081
Phone (614) 776-5750

625 Africa Rd
Ste 200
Westerville, OH 43082
Phone (614) 847-4100

570 Polaris Pkwy
Ste 250
Westerville, OH 43082
Phone (614) 459-0216

Organizations & group practices 4

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": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531958400000",
    "number": "1467542662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 AFRICA RD STE 200",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430829808",
            "telephone_number": "614-891-8080",
            "fax_number": "614-891-7078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 AFRICA RD STE 200",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "43082",
            "telephone_number": "614-891-8080",
            "fax_number": "614-891-7078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "KIMBERLY",
        "middle_name": "J",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2018-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.08946",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2702141",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westerville, OH

Sources for this page

Verify at the official NPI Registry.