Individual provider Active NPI

Heather L Krichbaum, CPNP

  • Pediatric Nurse Practitioner
  • Medina, OH
National Provider Identifier
1467599472
Registry record updated Oct 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN.313822-COA1 Issued in OH
Practice address
3360 Hardwood Rd
Medina, OH 44256
Phone
(419) 207-1085
Fax
(419) 207-0607
NPI assigned
Jan 31, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RN.313822-COA1 OH Primary

Addresses

Primary practice location

3360 Hardwood Rd
Medina, OH 44256

Mailing address

3360 Hardwood Hollow Rd
Medina, OH 44256-9693
Phone (614) 871-8500

Other names 1

  • Heather Lynn Pinkus Former name

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
I20101122000868 OH Practitioner - Nurse Practitioner 8123214731 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN.313822-COA1OHMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Metrohealth System CurrentSince Nov 1, 2021 Accepting new patients
The Metrohealth System CurrentSince Nov 1, 2021 Accepting new patients
The Metrohealth System Current Accepting new patients
University Hospitals Medical Group Inc CurrentSince Jan 17, 2017 Accepting new patients

Locations

2500 Metrohealth Dr
Cleveland, OH 44109
Phone (216) 778-2348

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

11100 Euclid Ave
Cleveland Heights, OH 44106

Interoperability endpoints

  • Direct secure messaging: hkrichbaum213782@direct.metrohealth.org

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": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414540800000",
    "number": "1467599472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3360 HARDWOOD HOLLOW RD",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442569693",
            "telephone_number": "614-871-8500",
            "fax_number": "614-871-4803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3360 HARDWOOD RD",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "44256",
            "telephone_number": "419-207-1085",
            "fax_number": "419-207-0607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRICHBAUM",
        "first_name": "HEATHER",
        "middle_name": "L",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2014-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OH",
            "license": "RN.313822-COA1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "PINKUS",
            "middle_name": "LYNN",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Medina, OH

Sources for this page

Verify at the official NPI Registry.