Individual provider Active NPI

Christie Dawn Wetzel, CNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Harrison, OH
National Provider Identifier
1689622722
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
NP-08371 Issued in OH
Practice address
10450 New Haven Rd
Harrison, OH 45030-2780
Phone
(513) 981-5852
Fax
(513) 367-8031
NPI assigned
May 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN-1086382 KY
Family Nurse Practitioner 363LF0000X NP-08371 OH
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN-1086382 KY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 82214 KS
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NP-08371 OH Primary

Addresses

Primary practice location

10450 New Haven Rd
Harrison, OH 45030-2780

Mailing address

10450 New Haven Rd
Harrison, OH 45030-2780
Phone (513) 981-5852

Other practice location 1

10450 New Haven Rd
Harrison, OH 45030-2780
Phone (513) 981-5852

Other identifiers 3

IdentifierTypeStateIssuer
200531140MedicaidIN
2595893MedicaidOH
78015369MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, VA, MN, KS4 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 4

Enrollment IDStateProvider typePAC IDDetails
I20220413001694 KY Practitioner - Nurse Practitioner 1355375049 Reassigns benefits to 1 organization
I20220503000321 VA Practitioner - Nurse Practitioner 1355375049 Reassigns benefits to 1 organization
I20230123000663 MN Practitioner - Nurse Practitioner 1355375049 Reassigns benefits to 2 organizations
I20230912002567 KS Practitioner - Nurse Practitioner 1355375049 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9773MNMDPhysical Therapist
82214KSMDPsychiatric/Mental Health Nurse Practitioner
RN-1086382KYMDPsychiatric/Mental Health Nurse Practitioner
NP-08371OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital District No 1 Crawford County CurrentSince Aug 1, 2023 Accepting new patients
Vernon J Harris East End Community Health Center CurrentSince Mar 1, 2022 Accepting new patients
Hospital District No 1 Crawford County CurrentSince Aug 1, 2023 Accepting new patients
Open Door Health Center CurrentSince Jan 3, 2023 Accepting new patients
Vernon J Harris East End Community Health Center Current Accepting new patients
Jennie Stuart Medical Center Inc CurrentSince Dec 5, 2022 Accepting new patients
Vernon J Harris East End Community Health Center CurrentSince Mar 1, 2022 Accepting new patients
Open Door Health Center CurrentSince Jan 3, 2023 Accepting new patients
County of Murray CurrentSince Feb 21, 2023 Accepting new patients
Jennie Stuart Medical Center Inc Family CurrentSince Dec 5, 2022 Accepting new patients
Jennie Stuart Medical Center Inc Family Current Accepting new patients

Locations

109 S Main St
Fort Scott, KS 66701
Phone (620) 223-7008

302 N Hospital Dr
Girard, KS 66743
Phone (620) 724-8291

222 W 18th St
Hopkinsville, KY 42240
Phone (270) 886-3962

105 Keeton Dr
Hopkinsville, KY 42240
Phone (270) 887-6565

10755 Eagle Way
Ste 202
Hopkinsville, KY 42240
Phone (270) 887-5640

309 Holly Ln
Mankato, MN 56001
Phone (507) 388-2120

2042 Juniper Ave
Slayton, MN 56172
Phone (507) 836-1227

2025 E Main St
Ste 105
Richmond, VA 23223
Phone (804) 253-1968

2809 North Ave
Ste 206
Richmond, VA 23222
Phone (804) 525-1818

1718 Williamsburg Rd
Richmond, VA 23231

719 N 25th St
Richmond, VA 23223
Phone (804) 253-1969

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EJBDAA

Organizations & group practices 11

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1689622722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10450 NEW HAVEN RD",
            "city": "HARRISON",
            "state": "OH",
            "postal_code": "450302780",
            "telephone_number": "513-981-5852",
            "fax_number": "513-367-8031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10450 NEW HAVEN RD",
            "city": "HARRISON",
            "state": "OH",
            "postal_code": "450302780",
            "telephone_number": "513-981-5852",
            "fax_number": "513-367-8031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10450 New Haven Rd",
            "address_purpose": "LOCATION",
            "city": "Harrison",
            "state": "OH",
            "postal_code": "450302780",
            "country_code": "US",
            "telephone_number": "513-981-5852",
            "fax_number": "513-367-8031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WETZEL",
        "first_name": "CHRISTIE",
        "middle_name": "DAWN",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "RN-1086382",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "NP-08371",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "RN-1086382",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KS",
            "license": "82214",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "NP-08371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200531140",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2595893",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78015369",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrison, OH

Sources for this page

Verify at the official NPI Registry.