Individual provider Active NPI

Jessie Christine Kiste, APRN-CNP

  • Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1689103152
Registry record updated Oct 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN.CNP.021273 Issued in OH
Practice address
452 W 10TH Ave
Columbus, OH 43210-1240
Phone
(614) 293-5502
Fax
(614) 293-4726
NPI assigned
Jun 8, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X APRN.CNP.021273 OH
Nurse Practitioner 363L00000X APRN.CNP.021273 OH Primary

Addresses

Primary practice location

452 W 10TH Ave
Columbus, OH 43210-1240

Mailing address

700 Ackerman Rd Ste 570
Columbus, OH 43202-1579
Phone (614) 366-8030

Other identifiers 1

IdentifierTypeStateIssuer
0240442MedicaidOH

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
I20170920003598 OH Practitioner - Nurse Practitioner 7416221023 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osu Surgery, LLCGroup PAC ID 0941105266, 207 clinicians

Practice addresses (Care Compare)

410 W 10TH Ave
Columbus, OH 43210-1240
Phone (614) 293-3230

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CNP.021273OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Osu Surgery, LLC Nurse Practitioner CurrentSince Sep 5, 2017 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

410 W 10th Ave
Columbus, OH 43210
Phone (614) 293-5905

452 W 10th Ave
Columbus, OH 43210

2050 Kenny Rd
Columbus, OH 43221
Phone (614) 293-8054

700 Ackerman Rd
Ste 570
Columbus, OH 43202
Phone (614) 293-2046

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.

Hospital & facility affiliations 5

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": "1496880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538352000000",
    "number": "1689103152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 570",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021579",
            "telephone_number": "614-366-8030",
            "fax_number": "614-366-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "452 W 10TH AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101240",
            "telephone_number": "614-293-5502",
            "fax_number": "614-293-4726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISTE",
        "first_name": "JESSIE",
        "middle_name": "CHRISTINE",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-08",
        "last_updated": "2018-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OH",
            "license": "APRN.CNP.021273",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.021273",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0240442",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.