Individual provider Active NPI

Sabrina Neeley, CNP

  • Family Nurse Practitioner
  • Kenton, OH
National Provider Identifier
1518441369
Registry record updated Sep 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.020742 Issued in OH
Practice address
111 W Espy St
Kenton, OH 43326-2117
Phone
(419) 679-5994
NPI assigned
Sep 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 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.020742 OH Primary

Addresses

Primary practice location

111 W Espy St
Kenton, OH 43326-2117

Mailing address

4422 Stemen St
Lima, OH 45807-9729
Phone (419) 371-1521

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, WA, NC, OR, CO5 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 5

Enrollment IDStateProvider typePAC IDDetails
I20181029002654 OH Practitioner - Nurse Practitioner 0941553549 Reassigns benefits to 1 organization
I20221011000648 WA Practitioner - Nurse Practitioner 0941553549 Reassigns benefits to 1 organization
I20221222002781 NC Practitioner - Nurse Practitioner 0941553549 Reassigns benefits to 1 organization
I20240828004301 OR Practitioner - Nurse Practitioner 0941553549 Reassigns benefits to 1 organization
I20250411002108 CO Practitioner - Nurse Practitioner 0941553549 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
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)

106 Langtree Village Dr
Suite 301
Mooresville, NC 28117-7594
Phone (888) 288-4715

1109 Oak Park Dr
Suite 125
Fort Collins, CO 80525-6215
Phone (888) 288-4715

111 SW Naito Pkwy
Suite 200
Portland, OR 97204-3512
Phone (503) 563-7370

20046 Walker Rd
Suite 7
Shaker Heights, OH 44122-3645
Phone (503) 208-5061

915 Broadway St
Suite 137
Vancouver, WA 98660-3278
Phone (503) 208-5061

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CNP.020742OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Boulder Care Provider Group PA CurrentSince Sep 1, 2022 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

205 E Benson Blvd
Ste 227
Anchorage, AK 99503

1109 Oak Park Dr
Ste 125
Fort Collins, CO 80525

106 Langtree Village Dr
Ste 301
Mooresville, NC 28117
Phone (704) 457-1368

150 Washington Ave
Ste 200
Santa Fe, NM 87501

20046 Walker Rd
Ste 7
Shaker Heights, OH 44122
Phone (503) 208-5061

111 SW Naito Pkwy
Ste 200
Portland, OR 97204
Phone (503) 208-5061

915 Broadway St
Ste 137
Vancouver, WA 98660
Phone (503) 208-5061

Organizations & group practices 2

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": "1537228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537228800000",
    "number": "1518441369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4422 STEMEN ST",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458079729",
            "telephone_number": "419-371-1521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W ESPY ST",
            "city": "KENTON",
            "state": "OH",
            "postal_code": "433262117",
            "telephone_number": "419-679-5994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEELEY",
        "first_name": "SABRINA",
        "name_prefix": "Miss",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-18",
        "last_updated": "2018-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.020742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenton, OH

Sources for this page

Verify at the official NPI Registry.