Individual provider Active NPI

Nicole Marie Warner, M.D.

  • MOHS-Micrographic Surgery Physician
  • Crestview Hills, KY
National Provider Identifier
1710244397
Registry record updated Mar 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
53968 Issued in KY
Practice address
651 Centre View Blvd
Crestview Hills, KY 41017-5423
Phone
(859) 301-6647
Fax
(859) 331-0809
NPI assigned
Apr 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD457774 PA
Dermatology Physician 207N00000X 53968 KY
Student in an Organized Health Care Education/Training Program 390200000X
MOHS-Micrographic Surgery Physician 207ND0101X 53968 KY Primary

Addresses

Primary practice location

651 Centre View Blvd
Crestview Hills, KY 41017-5423

Mailing address

PO Box 635283
Cincinnati, OH 45263-5283
Phone (859) 344-5555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, KY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170915002265 OH Practitioner - Dermatology 1850685793 Reassigns benefits to 1 organization
I20200916000099 KY Practitioner - DermatologyPractitioner - Micrographic Dermatologic Surgery (MDS) 1850685793 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
DermatologyAlso: Micrographic Dermatologic Surgery (MDS)
Education
Pennsylvania State University College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group IncGroup PAC ID 2163326240, 803 clinicians

Practice addresses (Care Compare)

651 Centre View Boulvard
Crestview Hills, KY 41017-5419
Phone (859) 331-6466

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision48
Removal of skin lesions34
Removal of skin cancer421
Removal of nail tissue1-10
Skin biopsy29

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD457774PAMDDermatology Physician
53968KYMDMOHS-Micrographic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Dermatology Group, Inc Dermatology CurrentSince Aug 1, 2017 Accepting new patients
Summit Medical Group, Inc Dermatology CurrentSince Oct 26, 2020 Accepting new patients
Summit Medical Group, Inc. CurrentSince Oct 26, 2020 Accepting new patients

Locations

330 Thomas More Pkwy
Ste 201
Crestview Hills, KY 41017
Phone (853) 934-4621

651 Centre View Blvd
Crestview Hills, KY 41017
Phone (859) 341-6660

7370 Turfway Rd
Florence, KY 41042
Phone (859) 212-5125

1980 Litton Ln
Hebron, KY 41048
Phone (859) 334-8700

300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217

1 Aviation Way
Cincinnati, OH 45215
Phone (513) 243-2946

5298 Socialville Foster Rd
Mason, OH 45040
Phone (513) 770-0953

Interoperability endpoints

  • Direct secure messaging: nwarner333155@direct-prd.stelizabeth.com
  • FHIR API: https://api.platform.athenahealth.com/5662/brand/1/csg/1/fhir/r4

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1334793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1710244397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635283",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635283",
            "telephone_number": "859-344-5555",
            "fax_number": "859-344-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 CENTRE VIEW BLVD",
            "city": "CRESTVIEW HILLS",
            "state": "KY",
            "postal_code": "410175423",
            "telephone_number": "859-301-6647",
            "fax_number": "859-331-0809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARNER",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-19",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD457774",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "KY",
            "license": "53968",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "KY",
            "license": "53968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestview Hills, KY

Sources for this page

Verify at the official NPI Registry.