Individual provider Active NPI

Stacey Beth Cruikshank

  • Family Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1487289286
Registry record updated Apr 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.026491 Issued in OH
Practice address
380 Butterfly Gardens Dr
Columbus, OH 43215-7508
Phone
(614) 722-2000
NPI assigned
Mar 12, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2026

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.026491 OH Primary

Addresses

Primary practice location

380 Butterfly Gardens Dr
Columbus, OH 43215-7508

Mailing address

700 Childrens Dr
Columbus, OH 43205-2664
Phone (614) 722-2000

Other practice location 1

1125 E Main St
Columbus, OH 43205-1931
Phone (614) 722-2000

Other practice location 2

26 Hospital Dr
Athens, OH 45701-2471
Phone (614) 722-2000

Other practice location 3

3553 Cleveland Ave
Columbus, OH 43224-2909
Phone (614) 722-2000

Other practice location 4

433 N Cleveland Ave
Westerville, OH 43082-8095
Phone (614) 722-2000

Other practice location 5

411 Industrial Mile Rd
Columbus, OH 43228-4322
Phone (614) 722-2000

Other practice location 6

579 S Yearling Rd
Columbus, OH 43213-2874
Phone (614) 722-2000

Other practice location 7

4766 W Broad St
Columbus, OH 43228-1613
Phone (614) 722-2000

Other practice location 8

4560 Morse Centre Rd
Columbus, OH 43229-6602
Phone (614) 722-2000

Other practice location 9

5070 N High St
Columbus, OH 43214-1526
Phone (614) 722-2000

Other practice location 10

1405 S High St
Columbus, OH 43207-1043
Phone (614) 722-2000

Other practice location 11

1777 E Dublin Granville Rd
Columbus, OH 43229-3502
Phone (614) 722-2000

Other practice location 12

1657 Georgesville Square Dr
Columbus, OH 43228-3689
Phone (614) 722-2000

Other practice location 13

882 S Hamilton Rd
Columbus, OH 43213-3003
Phone (614) 722-2000

Other practice location 14

700 Childrens Dr
Columbus, OH 43205-2664
Phone (614) 722-2000

Other practice location 15

2599 E. Hamilton Rd
Columbus, OH 43232-4323
Phone (614) 722-2000

Other practice location 16

2857 W Broad St
Columbus, OH 43204-2643
Phone (614) 722-2000

Other practice location 17

1390 Cleveland Ave
Columbus, OH 43211-2767
Phone (614) 722-2000

Other practice location 18

1350 Stringtown Rd
Grove City, OH 43123-9743
Phone (614) 722-2000

Other identifiers 1

IdentifierTypeStateIssuer
0425843MedicaidOH

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL grovecity Direct
CONNECT URL grovecity Direct

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
I20200409001205 OH Practitioner - Nurse Practitioner 4486083656 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Central Ohio Nutrition Center CurrentSince Mar 11, 2020 Accepting new patients
Central Ohio Nutrition Center, Inc CurrentSince Mar 11, 2020 Accepting new patients
Nationwide Children'S Hospital CurrentSince Sep 25, 2024 Accepting new patients
Pediatric Academic Association, Inc. Family CurrentSince Feb 1, 2021 Accepting new patients
Central Ohio Nutrition Center, Inc Current Accepting new patients
Nationwide Children'S Hospital Family CurrentSince Sep 25, 2024 Accepting new patients
Nationwide Children'S Hospital Past Accepting new patients

Locations

Dept 781629
Detroit, MI 48278

26 Hospital Dr
Athens, OH 45701
Phone (614) 722-2530

3553 Cleveland Ave
Columbus, OH 43224
Phone 6147222000 ext. 2620

5070 N High St
Columbus, OH 43214
Phone (614) 355-9500

1125 E Main St
Columbus, OH 43205
Phone (614) 355-9200

1390 Cleveland Ave
Columbus, OH 43211
Phone (614) 355-9306

Dept L289
Columbus, OH 43260

4766 W Broad St
Columbus, OH 43228
Phone (614) 851-7337

1657 Georgesville Square Dr
Columbus, OH 43228
Phone (614) 355-9702

4560 Morse Centre Rd
Columbus, OH 43229
Phone (614) 355-9400

2857 W Broad St
Columbus, OH 43204
Phone (614) 355-9900

700 Childrens Dr
Columbus, OH 43205
Phone (614) 722-4411

1777 E Dublin Granville Rd
Columbus, OH 43229
Phone (614) 355-9700

380 Butterfly Gardens Dr
Columbus, OH 43215
Phone (614) 355-0569

1405 S High St
Columbus, OH 43207
Phone (614) 293-3330

1 Childrens Plz
Dayton, OH 45404
Phone (937) 641-3600

648 Taylor Rd
Gahanna, OH 43230
Phone (614) 864-7225

1350 Stringtown Rd
Grove City, OH 43123
Phone (614) 875-3444

433 N Cleveland Ave
Westerville, OH 43082
Phone (614) 355-8300

882 S Hamilton Rd
Whitehall, OH 43213
Phone (614) 235-5555

579 S Yearling Rd
Whitehall, OH 43213
Phone (614) 355-9800

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.

NPI Registry JSON

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

{
    "created_epoch": "1583971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776124800000",
    "number": "1487289286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 CHILDRENS DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052664",
            "telephone_number": "614-722-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 BUTTERFLY GARDENS DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432157508",
            "telephone_number": "614-722-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1125 E Main St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432051931",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "26 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "OH",
            "postal_code": "457012471",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3553 Cleveland Ave",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432242909",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "433 N Cleveland Ave",
            "address_purpose": "LOCATION",
            "city": "Westerville",
            "state": "OH",
            "postal_code": "430828095",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "411 Industrial Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432284322",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "579 S Yearling Rd",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432132874",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4766 W Broad St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432281613",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4560 Morse Centre Rd",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432296602",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5070 N High St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432141526",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1405 S High St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432071043",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1777 E Dublin Granville Rd",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432293502",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1657 Georgesville Square Dr",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432283689",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "882 S Hamilton Rd",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432133003",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "700 Childrens Dr",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432052664",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2599 E. Hamilton Rd",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432324323",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2857 W Broad St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432042643",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1390 Cleveland Ave",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432112767",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1350 Stringtown Rd",
            "address_purpose": "LOCATION",
            "city": "Grove City",
            "state": "OH",
            "postal_code": "431239743",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRUIKSHANK",
        "first_name": "STACEY",
        "middle_name": "BETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-12",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.026491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0425843",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "grovecity",
            "affiliation": "N",
            "endpointDescription": "city",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1901 Ohio Dr",
            "city": "Grove City",
            "state": "OH",
            "country_code": "US",
            "postal_code": "431234835",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "grovecity",
            "affiliation": "N",
            "endpointDescription": "city",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1901 Ohio Dr",
            "city": "Grove City",
            "state": "OH",
            "country_code": "US",
            "postal_code": "431234835",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.