Individual provider Active NPI

Nikole Marie Kerns

  • Obstetrics & Gynecology Physician
  • Wright Patterson Afb, OH
National Provider Identifier
1750021754
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
01092566A Issued in IN
Practice address
4881 Sugar Maple Dr
Wright Patterson Afb, OH 45433-5529
Phone
(937) 522-2778
NPI assigned
Mar 30, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 01092566A IN Primary

Addresses

Primary practice location

4881 Sugar Maple Dr
Wright Patterson Afb, OH 45433-5529

Mailing address

4881 Sugar Maple Dr
Wright Patterson Afb, OH 45433-5529
Phone (814) 215-0381

Other practice location 1

161 Wyoming St Ste 100W
Dayton, OH 45409-2741
Phone (937) 208-0500

Other practice location 2

400 Sugar Camp Cir Ste 101
Oakwood, OH 45409-1981
Phone (937) 567-6700

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220526000595 OH Order and Referring Only - Obstetrics/GynecologyPractitioner - Obstetrics/Gynecology 9638557085

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
57.253067OHMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1648598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1750021754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4881 SUGAR MAPLE DR",
            "city": "WRIGHT PATTERSON AFB",
            "state": "OH",
            "postal_code": "454335529",
            "telephone_number": "814-215-0381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4881 SUGAR MAPLE DR",
            "city": "WRIGHT PATTERSON AFB",
            "state": "OH",
            "postal_code": "454335529",
            "telephone_number": "937-522-2778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "161 Wyoming St Ste 100W",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454092741",
            "country_code": "US",
            "telephone_number": "937-208-0500",
            "fax_number": "937-641-7072",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 Sugar Camp Cir Ste 101",
            "address_purpose": "LOCATION",
            "city": "Oakwood",
            "state": "OH",
            "postal_code": "454091981",
            "country_code": "US",
            "telephone_number": "937-567-6700",
            "fax_number": "937-641-2629",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KERNS",
        "first_name": "NIKOLE",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-30",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IN",
            "license": "01092566A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wright Patterson Afb, OH

Sources for this page

Verify at the official NPI Registry.