Individual provider Active NPI

Kelly Ryan Kachoris

  • Gerontology Nurse Practitioner
  • Cincinnati, OH
National Provider Identifier
1497411268
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
CNP.0030254 Issued in OH
Practice address
7502 State Rd Ste 2210a
Cincinnati, OH 45255-2596
Phone
(513) 624-2070
NPI assigned
Nov 16, 2021
Last updated
May 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 263651 OH
Acute Care Nurse Practitioner 363LA2100X 0030254 OH
Gerontology Nurse Practitioner 363LG0600X CNP.0030254 OH Primary

Addresses

Primary practice location

7502 State Rd Ste 2210a
Cincinnati, OH 45255-2596

Mailing address

7502 State Rd Ste 2210a
Cincinnati, OH 45255-2596
Phone (513) 624-2070

Other practice location 1

7613 Cathedral Hills Dr
Cincinnati, OH 45244-2913
Phone (513) 722-5330

Other practice location 2

10600 Montgomery Rd Ste 300
Montgomery, OH 45242-4464
Phone (513) 853-9250

Other identifiers 2

IdentifierTypeStateIssuer
0462231MedicaidOH
2565399MedicaidOH

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
I20211221001687 OH Practitioner - Nurse Practitioner 3971994278 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7502 State Rd
Suite 2210a
Cincinnati, OH 45255-2596
Phone (513) 751-4222

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
263651OHMDRegistered Nurse
0030254OHMDAcute Care Nurse Practitioner
CNP.0030254OHMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Cincinnati Specialty Care LLC CurrentSince May 30, 2023 Accepting new patients
Trihealth G, LLC CurrentSince Nov 21, 2021 Accepting new patients
Trihealth G LLC CurrentSince Nov 21, 2021 Accepting new patients
Mercy Health Physicians Cincinnati Specialty Care LLC CurrentSince May 30, 2023 Accepting new patients
Trihealth H LLC CurrentSince Nov 21, 2021 Accepting new patients
Trihealth G LLC Past Accepting new patients
Trihealth Physician Institute Past Accepting new patients

Locations

2001 Anderson Ferry Rd
Cincinnati, OH 45238
Phone (513) 922-1200

375 Dixmyth Ave
Cincinnati, OH 45220
Phone (513) 862-2432

375 Dixmyth Ave
Ste 3135
Cincinnati, OH 45220
Phone (513) 862-3452

4685 Forest Ave
Cincinnati, OH 45212
Phone (513) 853-4721

7502 State Rd
Ste 2210A
Cincinnati, OH 45255
Phone (513) 624-2070

9070 Winton Rd
Cincinnati, OH 45231
Phone (513) 246-2750

201 Old Bank Rd
Ste 103
Milford, OH 45150
Phone (513) 248-0100

10600 Montgomery Rd
Ste 300
Montgomery, OH 45242
Phone (513) 984-2510

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1637020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1497411268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7502 STATE RD STE 2210A",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452552596",
            "telephone_number": "513-624-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7502 STATE RD STE 2210A",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452552596",
            "telephone_number": "513-624-2070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7613 Cathedral Hills Dr",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452442913",
            "country_code": "US",
            "telephone_number": "513-722-5330",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10600 Montgomery Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Montgomery",
            "state": "OH",
            "postal_code": "452424464",
            "country_code": "US",
            "telephone_number": "513-853-9250",
            "fax_number": "513-281-1908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KACHORIS",
        "first_name": "KELLY",
        "middle_name": "RYAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-16",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "263651",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "0030254",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OH",
            "license": "CNP.0030254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0462231",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2565399",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.