Individual provider Active NPI

Keri N Hollencamp, CNP

  • Nurse Practitioner
  • Middletown, OH
National Provider Identifier
1578801338
Registry record updated Jun 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
COA.14263-NP Issued in OH
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

Updated by the provider on Jun 10, 2026

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 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

IdentifierTypeStateIssuer
0079110MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, KY2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20130304000016 OH Practitioner - Nurse Practitioner 3476708165 Reassigns benefits to 1 organization
I20251231004000 KY Practitioner - Nurse Practitioner 3476708165 Reassigns benefits to 1 organization

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
Medicine Inpatient Group LLCGroup PAC ID 3577645340, 39 clinicians

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 100Reported as group
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

LicenseStateTypeSpecialty
COA.14263-NPOHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew 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.

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

Verify at the official NPI Registry.