Individual provider Active NPI

Estella J Wetzel, FNP-C

  • Nurse Practitioner
  • Beavercreek, OH
National Provider Identifier
1548698574
Registry record updated Apr 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN.CNP.15251 Issued in OH
Practice address
1911 N Fairfield Rd Ste 110
Beavercreek, OH 45432-2754
Phone
(937) 429-4369
Fax
(937) 429-4575
NPI assigned
Oct 30, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN.CNP.15251 OH Primary

Addresses

Primary practice location

1911 N Fairfield Rd Ste 110
Beavercreek, OH 45432-2754

Mailing address

3170 Kettering Blvd BLDG B3
Moraine, OH 45439-1924
Phone (937) 991-3191

Other practice location 1

1244 Meadow Bridge Dr Ste 100
Beavercreek, OH 45434-6388
Phone (937) 208-7600

Other practice location 2

4449 State Route 159
Chillicothe, OH 45601-8620
Phone (740) 775-1260

Other practice location 3

630 N Main St
Springboro, OH 45066-7519
Phone (937) 748-4211

Other practice location 4

8638 Old Troy Pike Ste A
Huber Heights, OH 45424-1051
Phone (937) 237-1574

Other practice location 5

4449 State Route 159
Chillicothe, OH 45601-8620
Phone (740) 775-1260

Other identifiers 1

IdentifierTypeStateIssuer
0116291MedicaidOH

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
I20140327000560 OH Practitioner - Nurse Practitioner 3779714100 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN.CNP.15251OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Family Care Inc CurrentSince May 31, 2016 Accepting new patients
Mvhe Inc CurrentSince Aug 31, 2016 Accepting new patients
Regional Occupational Health Clinics, LLC CurrentSince Jan 8, 2014 Accepting new patients
Mvhe Inc CurrentSince Aug 31, 2016 Accepting new patients
Scioto Paint Valley Mental Health Center Past Accepting new patients

Locations

1911 N Fairfield Rd
Ste 110
Beavercreek, OH 45432
Phone (937) 376-2571

1244 Meadow Bridge Dr
Ste 100
Beavercreek, OH 45434
Phone (937) 208-7600

2451 Wayne Ave
Dayton, OH 45420
Phone (937) 252-1831

1530 Needmore Rd
Ste 200
Dayton, OH 45414
Phone (937) 278-5854

8638 Old Troy Pike
Ste A
Huber Heights, OH 45424
Phone (937) 237-1574

630 N Main St
Springboro, OH 45066
Phone (937) 748-4211

1835 E High St
Ste 2
Springfield, OH 45505
Phone (937) 322-8977

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/spvmhc/r4/

Organizations & group practices 5

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": "1383091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555545600000",
    "number": "1548698574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3170 KETTERING BLVD BLDG B3",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454391924",
            "telephone_number": "937-991-3191",
            "fax_number": "937-223-9811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 N FAIRFIELD RD STE 110",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454322754",
            "telephone_number": "937-429-4369",
            "fax_number": "937-429-4575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1244 Meadow Bridge Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Beavercreek",
            "state": "OH",
            "postal_code": "454346388",
            "country_code": "US",
            "telephone_number": "937-208-7600",
            "fax_number": "937-208-7620",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4449 State Route 159",
            "address_purpose": "LOCATION",
            "city": "Chillicothe",
            "state": "OH",
            "postal_code": "456018620",
            "country_code": "US",
            "telephone_number": "740-775-1260",
            "fax_number": "740-773-1264",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "630 N Main St",
            "address_purpose": "LOCATION",
            "city": "Springboro",
            "state": "OH",
            "postal_code": "450667519",
            "country_code": "US",
            "telephone_number": "937-748-4211",
            "fax_number": "937-748-3566",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8638 Old Troy Pike Ste A",
            "address_purpose": "LOCATION",
            "city": "Huber Heights",
            "state": "OH",
            "postal_code": "454241051",
            "country_code": "US",
            "telephone_number": "937-237-1574",
            "fax_number": "937-237-1954",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4449 State Route 159",
            "address_purpose": "LOCATION",
            "city": "Chillicothe",
            "state": "OH",
            "postal_code": "456018620",
            "country_code": "US",
            "telephone_number": "740-775-1260",
            "fax_number": "740-773-1264",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WETZEL",
        "first_name": "ESTELLA",
        "middle_name": "J",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-30",
        "last_updated": "2019-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.15251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0116291",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beavercreek, OH

Sources for this page

Verify at the official NPI Registry.