Individual provider Active NPI

Hayley R Burnett, MS, ACNP-BC

  • Acute Care Nurse Practitioner
  • Miamisburg, OH
National Provider Identifier
1649577420
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
APRN.CNP.12195 Issued in OH
Practice address
4000 Miamisburg Centerville Rd Ste 10
Miamisburg, OH 45342-7615
Phone
(937) 384-4820
Fax
(937) 384-4826
NPI assigned
Feb 14, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X COA12195-NP OH
Acute Care Nurse Practitioner 363LA2100X APRN.CNP.12195 OH Primary

Addresses

Primary practice location

4000 Miamisburg Centerville Rd Ste 10
Miamisburg, OH 45342-7615

Mailing address

1 Prestige PL Ste 550
Miamisburg, OH 45342-6115
Phone (937) 762-1310

Other identifiers 3

IdentifierTypeStateIssuer
0054621MedicaidOH
H046133OtherOHMEDICARE PTAN
P01597077OtherOHRRMEDICARE PTAN

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/
Direct Messaging Address hburnett470840@direct.ketteringhealth.org

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
I20111206000719 OH Practitioner - Nurse Practitioner 7214102037 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ravi Desai MD LLCGroup PAC ID 9931579554, 2 clinicians
Kettering Independent Medical Group IncGroup PAC ID 3173710936, 699 clinicians

Practice addresses (Care Compare)

250 W Social Row Rd
Centerville, OH 45458-4404
Phone (937) 886-8800

4000 Miamisburg Centerville Rd
Suite 100
Miamisburg, OH 45342-7615
Phone (937) 866-0637

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.34 of 100Reported as group
Quality
63.67
Promoting interoperability
100
Improvement activities
40
Cost
74.14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
COA12195-NPOHMDNurse Practitioner
APRN.CNP.12195OHMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ravi Desai MD LLC Acute Care CurrentSince Apr 10, 2023 Accepting new patients
Kettering Independent Medical Group Inc CurrentSince Jun 13, 2024 Accepting new patients
Metro Golden Medical, LLC CurrentSince Jun 20, 2022 Accepting new patients

Locations

4403 Far Hills Ave
Kettering, OH 45429
Phone (937) 395-3910

3533 Southern Blvd
Ste 5800
Kettering, OH 45429
Phone (937) 439-3600

4000 Miamisburg Centerville Rd
Ste 405
Miamisburg, OH 45342
Phone (937) 439-3600

4000 Miamisburg Centerville Rd
Ste 10
Miamisburg, OH 45342
Phone (937) 384-4820

4000 Miamisburg Centerville Rd
Ste 100
Miamisburg, OH 45342
Phone (937) 643-9939

1 Prestige Pl
Ste 550
Miamisburg, OH 45342
Phone (937) 752-2306

4000 Miamisburg Centerville Rd
Ste 450
Miamisburg, OH 45342
Phone (937) 439-3600

3421 Pinnacle Rd
Moraine, OH 45439
Phone (937) 268-3488

250 W Social Row Rd
Washington Township, OH 45458
Phone (937) 573-7452

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1297641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1649577420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PRESTIGE PL STE 550",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453426115",
            "telephone_number": "937-762-1310",
            "fax_number": "937-384-4826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 MIAMISBURG CENTERVILLE RD STE 10",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453427615",
            "telephone_number": "937-384-4820",
            "fax_number": "937-384-4826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNETT",
        "first_name": "HAYLEY",
        "middle_name": "R",
        "credential": "MS, ACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-14",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "COA12195-NP",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "APRN.CNP.12195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0054621",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "H046133",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMEDICARE PTAN",
            "identifier": "P01597077",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "4000 Miamisburg Centerville Rd Ste 10",
            "city": "Miamisburg",
            "state": "OH",
            "country_code": "US",
            "postal_code": "453427615",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hburnett470840@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "4000 Miamisburg Centerville Rd Ste 10",
            "city": "Miamisburg",
            "state": "OH",
            "country_code": "US",
            "postal_code": "453427615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Miamisburg, OH

Sources for this page

Verify at the official NPI Registry.