Active NPI
Kelley Lynn Beane, CPNP
- Pediatric Nurse Practitioner
- Columbus, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- COA.07909
- Practice address
- 700 Childrens Dr
Columbus, OH 43205-2664 - Phone
- (614) 722-4459
- Fax
- (614) 722-4458
- NPI assigned
- Jun 30, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | COA.07909 | OH | |
| Pediatric Nurse Practitioner | 363LP0200X | COA.07909 | OH | Primary |
Addresses
Primary practice location
700 Childrens Dr
Columbus, OH 43205-2664
Mailing address
561 Dowling St
Ashville, OH 43103-2504
Phone (740) 983-1066
Other practice location 1
433 N Cleveland Ave
Westerville, OH 43082-8095
Phone (614) 722-2000
Other practice location 2
4363 All Seasons Dr
Hilliard, OH 43026-2050
Phone (614) 722-2000
Other practice location 3
7853 Pacer Dr
Delaware, OH 43015-7571
Phone (614) 722-2000
Other practice location 4
555 S 18th St
Columbus, OH 43205-2654
Phone (614) 722-2000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2693189 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Pediatric Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| COA.07909 | OH | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Academic Association, Inc. | Pediatrics | Current | Accepting new patients |
Locations
555 S 18th St
Columbus, OH 43205
Phone (614) 722-4554
Dept L289
Columbus, OH 43260
700 Childrens Dr
Columbus, OH 43205
Phone (614) 722-4411
7853 Pacer Dr
Delaware, OH 43015
Phone (614) 355-7900
433 N Cleveland Ave
Westerville, OH 43082
Phone (614) 355-8300
Organizations & group practices 1
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.
-
- Pediatrics Physician
- Columbus, OH
- NPI 1063419943
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645574400000",
"number": "1578592804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "561 DOWLING ST",
"city": "ASHVILLE",
"state": "OH",
"postal_code": "431032504",
"telephone_number": "740-983-1066"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 CHILDRENS DR",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432052664",
"telephone_number": "614-722-4459",
"fax_number": "614-722-4458"
}
],
"practiceLocations": [
{
"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": "4363 All Seasons Dr",
"address_purpose": "LOCATION",
"city": "Hilliard",
"state": "OH",
"postal_code": "430262050",
"country_code": "US",
"telephone_number": "614-722-2000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "7853 Pacer Dr",
"address_purpose": "LOCATION",
"city": "Delaware",
"state": "OH",
"postal_code": "430157571",
"country_code": "US",
"telephone_number": "614-722-2000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "555 S 18th St",
"address_purpose": "LOCATION",
"city": "Columbus",
"state": "OH",
"postal_code": "432052654",
"country_code": "US",
"telephone_number": "614-722-2000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BEANE",
"first_name": "KELLEY",
"middle_name": "LYNN",
"credential": "CPNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-30",
"last_updated": "2022-02-23",
"certification_date": "2022-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "OH",
"license": "COA.07909",
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "OH",
"license": "COA.07909",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2693189",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.