Individual provider Active NPI

Elizabeth A Theado, RN, NNP

  • Neonatal Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1679860159
Registry record updated Apr 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
APRN.CNP.12547 Issued in OH
Practice address
700 Childrens Dr
Columbus, OH 43205-2664
Phone
(614) 722-4654
NPI assigned
Jul 5, 2011
Last updated
Apr 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X APRN.CNP.12547 OH Primary
Critical Care Neonatal Nurse Practitioner 363LN0005X APRN.CNP.12547 OH
Neonatal Intensive Care Registered Nurse 163WN0002X 316344 OH

Addresses

Primary practice location

700 Childrens Dr
Columbus, OH 43205-2664

Mailing address

1678 Dollivor Dr
Columbus, OH 43235-1106
Phone (614) 353-3715

Other identifiers 1

IdentifierTypeStateIssuer
0082623MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
316344OHMDNeonatal Intensive Care Registered Nurse
APRN.CNP.12547OHMDCritical Care Neonatal Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: etheado3180129@direct.trinity-health.org

NPI Registry JSON

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

{
    "created_epoch": "1309824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745539200000",
    "number": "1679860159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1678 DOLLIVOR DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432351106",
            "telephone_number": "614-353-3715"
        },
        {
            "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": "614-722-4654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEADO",
        "first_name": "ELIZABETH",
        "middle_name": "A",
        "credential": "RN, NNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-05",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "OH",
            "license": "APRN.CNP.12547",
            "primary": true
        },
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "OH",
            "license": "APRN.CNP.12547",
            "primary": false
        },
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "OH",
            "license": "316344",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0082623",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.