Individual provider Active NPI

Kodi McClaskey, CNP

  • Family Nurse Practitioner
  • Lancaster, OH
National Provider Identifier
1659102887
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.0037266 Issued in OH
Practice address
135 N Ewing St Ste 204
Lancaster, OH 43130-3378
Phone
(740) 689-4925
NPI assigned
Aug 9, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.0037266 OH Primary

Addresses

Primary practice location

135 N Ewing St Ste 204
Lancaster, OH 43130-3378

Mailing address

317 E Wheeling St
Lancaster, OH 43130-3818
Phone (740) 405-7601

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
I20240923002072 OH Practitioner - Nurse Practitioner 8921549577 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairfield Healthcare Professionals IncGroup PAC ID 4789596362, 144 clinicians

Practice addresses (Care Compare)

135 N Ewing St
Suite 204
Lancaster, OH 43130-3378
Phone (740) 687-8888

Hospital & facility affiliations

  • Fairfield Medical Center Hospital, Lancaster, OH, CCN 360072

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0037266OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fairfield Healthcare Professionals, Inc. CurrentSince Aug 25, 2024 Accepting new patients
Fairfield Healthcare Professionals Inc Current Accepting new patients
Fairfield Healthcare Professionals, Inc. Past Accepting new patients

Locations

135 N Ewing St
Ste 204
Lancaster, OH 43130
Phone (740) 689-4925

401 N Ewing St
Lancaster, OH 43130
Phone (740) 687-8000

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 1

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": "1723161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1659102887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 E WHEELING ST",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431303818",
            "telephone_number": "740-405-7601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 N EWING ST STE 204",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431303378",
            "telephone_number": "740-689-4925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLASKEY",
        "first_name": "KODI",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-09",
        "last_updated": "2024-08-09",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0037266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, OH

Sources for this page

Verify at the official NPI Registry.