Individual provider Active NPI

Steven Daniel Wang, APRN-CNP, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Dublin, OH
National Provider Identifier
1700657533
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN.CNP.0034673 Issued in OH
Practice address
4995 Bradenton Ave Ste 110
Dublin, OH 43017-3551
Phone
(614) 515-2500
Fax
(614) 573-0530
NPI assigned
Jan 10, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.490313 OH
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN.CNP.0034673 OH Primary

Addresses

Primary practice location

4995 Bradenton Ave Ste 110
Dublin, OH 43017-3551

Mailing address

4995 Bradenton Ave Ste 110
Dublin, OH 43017-3551
Phone (614) 973-3114

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
I20240416001025 OH Practitioner - Nurse Practitioner 4284073883 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Keystone Mental Health, IncGroup PAC ID 9234417379, 8 clinicians

Practice addresses (Care Compare)

6810 Perimeter Dr
Suite 100B
Dublin, OH 43016-8013
Phone (614) 569-9496

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN.490313OHMDRegistered Nurse
APRN.CNP.0034673OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Keystone Mental Health, Inc. CurrentSince Mar 28, 2024 Accepting new patients
Columbus Physicians Group LLC CurrentSince Jan 14, 2024 Accepting new patients
Keystone Psychiatry, Inc. PastSince Jan 19, 2020 Accepting new patients

Locations

4995 Bradenton Ave
Ste 110
Dublin, OH 43017
Phone (614) 515-2500

7625 Hospital Dr
Dublin, OH 43016
Phone (614) 414-2277

6810 Perimeter Dr
Ste 100B
Dublin, OH 43016
Phone (614) 495-8840

Organizations & group practices 4

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": "1704844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1700657533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4995 BRADENTON AVE STE 110",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430173551",
            "telephone_number": "614-973-3114",
            "fax_number": "614-573-0530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4995 BRADENTON AVE STE 110",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430173551",
            "telephone_number": "614-515-2500",
            "fax_number": "614-573-0530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "STEVEN",
        "middle_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "APRN-CNP, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-10",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.490313",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0034673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, OH

Sources for this page

Verify at the official NPI Registry.