Individual provider Active NPI

Judy L Kosnikowski, CNP

  • Family Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1710204631
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
10295-NP Issued in OH
Practice address
111 S Grant Ave Ste 208
Columbus, OH 43215-4701
Phone
(614) 566-9143
Fax
(614) 566-8080
NPI assigned
May 2, 2010
Last updated
Jan 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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 10295-NP OH Primary

Addresses

Primary practice location

111 S Grant Ave Ste 208
Columbus, OH 43215-4701

Mailing address

5450 Frantz Rd Ste 360
Dublin, OH 43016-4141

Other identifiers 1

IdentifierTypeStateIssuer
3048222MedicaidOH

Other names 1

  • Judy LK Wagner Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jwagner12741@direct.ohiohealth.com OhioHealth Physician Group

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
I20100707000178 OH Practitioner - Nurse Practitioner 2769513852 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohiohealth CorporationGroup PAC ID 6305758426, 2,295 clinicians

Practice addresses (Care Compare)

111 S Grant Ave
2ND FL
Columbus, OH 43215-4701
Phone (614) 566-9143

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.04 of 100Reported as group
Quality
58.67
Promoting interoperability
98
Improvement activities
40
Cost
76.46

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10295-NPOHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation CurrentSince Apr 18, 2010 Accepting new patients
Ohiohealth Corporation CurrentSince Apr 18, 2010 Accepting new patients
Ohiohealth Corporation CurrentSince May 31, 2020 Accepting new patients

Locations

111 S Grant Ave
Columbus, OH 43215
Phone (614) 461-3232

111 S Grant Ave
Fl 2
Columbus, OH 43215
Phone (614) 566-9143

111 S Grant Ave
Ste 208
Columbus, OH 43215
Phone (614) 566-9143

3773 Olentangy River Rd
Lowr Lev
Columbus, OH 43214

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

Dept L3652
Columbus, OH 43260

561 W Central Ave
Delaware, OH 43015
Phone (614) 566-9983

5350 Frantz Rd
Dublin, OH 43016

5450 Frantz Rd
Ste 360
Dublin, OH 43016
Phone (614) 533-6497

Interoperability endpoints

  • Direct secure messaging: jwagner12741@direct.ohiohealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1272758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1710204631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 FRANTZ RD STE 360",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430164141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S GRANT AVE STE 208",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432154701",
            "telephone_number": "614-566-9143",
            "fax_number": "614-566-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSNIKOWSKI",
        "first_name": "JUDY",
        "middle_name": "L",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-02",
        "last_updated": "2022-01-25",
        "certification_date": "2020-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "10295-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3048222",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwagner12741@direct.ohiohealth.com",
            "affiliation": "Y",
            "affiliationName": "OhioHealth Physician Group",
            "address_1": "561 W Central Ave",
            "city": "Delaware",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430151410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JUDY",
            "last_name": "WAGNER",
            "middle_name": "LK",
            "credential": "CNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.