Individual provider Active NPI

Kelley Lynn Beane, CPNP

  • Pediatric Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1578592804
Registry record updated Feb 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
COA.07909 Issued in OH
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

Updated by the provider on Feb 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
2693189MedicaidOH

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
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
COA.07909OHMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Academic Association, Inc. Pediatrics CurrentSince Feb 6, 2016 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.

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

Verify at the official NPI Registry.