Christine Mautz

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

020301 Issued in OH

Practice address

100 Blackstone CT
Granville, OH 43023-8032

Phone

(740) 616-6903

NPI assigned

Dec 22, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH, WA, OR, NC, PA, KY6 enrollments

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 6

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Boulder Care Provider Group PAGroup PAC ID 6901217447, 115 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Boulder Care Provider Group PA

  dba Boulder Care

  • Addiction Medicine (Family Medicine) Physician
  • Portland, OR
  • NPI 1649838590

  NC, OH, PA, WA

  Medicare reassignment Care Compare group NPD
• First Step Recovery Center

  • Addiction Medicine (Family Medicine) Physician
  • Reynoldsburg, OH
  • NPI 1467826453
  Medicare reassignment NPD
• Pursuecare, LLC

  • Addiction Medicine (Preventive Medicine) Physician
  • Middletown, CT
  • NPI 1962068296

  KY, OH

  Medicare reassignment
• First Step Recovery Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Reynoldsburg, OH
  • NPI 1477004810
  NPD
• Cornerstone Project, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Dayton, OH
  • NPI 1639609548
  NPD (past)

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

{
    "created_epoch": "1482364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482364800000",
    "number": "1467997767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BLACKSTONE CT",
            "city": "GRANVILLE",
            "state": "OH",
            "postal_code": "430238032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BLACKSTONE CT",
            "city": "GRANVILLE",
            "state": "OH",
            "postal_code": "430238032",
            "telephone_number": "740-616-6903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAUTZ",
        "first_name": "CHRISTINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-22",
        "last_updated": "2016-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "020301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelcie Lupher, QMHS
• Angela Lykins
• Alma Joy Maclean
• Matthew Pingel DMD LLC (Granville Pediatric Dentistry)
• Kyle Matthewson, ATC
• Marci McCaulay, PH.D.
• Cynthia McElroy, LISW
• Leslie McNemar, LMT
• Cheryl Meisterman, PHD
• Mid-Ohio Counseling, LLC

• Family Nurse Practitioner in Granville, OH
• Providers in Granville, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2016; 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.

Verify at the official NPI Registry.