Active NPI
Keri N Hollencamp, CNP
- Nurse Practitioner
- Middletown, OH
National Provider Identifier
1578801338
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- COA.14263-NP
- Practice address
- 200 Medical Center Dr
Ste 180B
Middletown, OH 45005-5200 - Phone
- (513) 420-8030
- Fax
- (513) 425-7202
- NPI assigned
- Jan 29, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | COA.14263-NP | OH | Primary |
Addresses
Primary practice location
200 Medical Center Dr
Ste 180B
Middletown, OH 45005-5200
Mailing address
200 Medical Center Dr Ste 180B
Middletown, OH 45005-2593
Phone (513) 420-8030
Other practice location 1
30 E Apple St Ste 1480
Dayton, OH 45409-2939
Phone (937) 208-7240
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0079110 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH, KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Medical Ctr Dr
Middletown, OH 45005-2584
Phone (513) 974-2111
6975 Burlington Pike
Florence, KY 41042-1618
Phone (513) 605-5000
Merit-based Incentive Payment System (MIPS)
- Final score
- 57.66 of 100
- Quality
- 47.87
- Promoting interoperability
- 0
- Improvement activities
- 40
- Cost
- 70.71
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| COA.14263-NP | OH | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Premier Health Specialists Inc | Past | Accepting new patients |
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.
-
- Foot & Ankle Surgery Podiatrist
- Dayton, OH
- NPI 1902211287
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1359417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781049600000",
"number": "1578801338",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 MEDICAL CENTER DR STE 180B",
"city": "MIDDLETOWN",
"state": "OH",
"postal_code": "450052593",
"telephone_number": "513-420-8030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 MEDICAL CENTER DR",
"address_2": "STE 180B",
"city": "MIDDLETOWN",
"state": "OH",
"postal_code": "450055200",
"telephone_number": "513-420-8030",
"fax_number": "513-425-7202"
}
],
"practiceLocations": [
{
"address_1": "30 E Apple St Ste 1480",
"address_purpose": "LOCATION",
"city": "Dayton",
"state": "OH",
"postal_code": "454092939",
"country_code": "US",
"telephone_number": "937-208-7240",
"fax_number": "937-208-7242",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HOLLENCAMP",
"first_name": "KERI",
"middle_name": "N",
"credential": "CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-01-29",
"last_updated": "2026-06-10",
"certification_date": "2026-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "OH",
"license": "COA.14263-NP",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0079110",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Middletown, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.