Individual provider Active NPI

Michelle Aimee Caesar, APRN

  • Gerontology Nurse Practitioner
  • Springfield, OH
National Provider Identifier
1750509642
Registry record updated Feb 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN.CNP.17178 Issued in OH
Practice address
200 Medical Center Dr Ste a
Springfield, OH 45504-2688
Phone
(937) 523-9480
Fax
(937) 523-9490
NPI assigned
Apr 23, 2007
Last updated
Feb 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X APRN.CNP.17178 OH Primary
Registered Nurse 163W00000X 309419 OH

Addresses

Primary practice location

200 Medical Center Dr Ste a
Springfield, OH 45504-2688

Mailing address

200 Medical Center Dr Ste a
Springfield, OH 45504-2688
Phone (937) 523-9480

Other practice location 1

3533 Southern Blvd
Suite 5200
Kettering, OH 45429-1264
Phone (937) 439-6186

Other identifiers 2

IdentifierTypeStateIssuer
0180984MedicaidOH
APRN.CNP. 17178OtherOHSTATE LICENSE - OHIO

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/
Direct Messaging Address mcaesar6014@direct.ketteringhealth.org

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
I20160927000877 OH Practitioner - Nurse Practitioner 2466749916 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Cincinnati College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Health Physicians Springfield Specialty Care LLCGroup PAC ID 4284059981, 129 clinicians

Practice addresses (Care Compare)

200 Medical Ctr Dr
Springfield, OH 45504-2688
Phone (937) 523-9051

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
309419OHMDRegistered Nurse
APRN.CNP.17178OHMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kettering Independent Medical Group Inc CurrentSince Dec 29, 2022 Accepting new patients
Mercy Health Physicians Springfield Specialty Care LLC CurrentSince Mar 12, 2023 Accepting new patients

Locations

3533 Southern Blvd
Ste 5200
Kettering, OH 45429
Phone (937) 395-8002

3700 Southern Blvd
Ste 300
Kettering, OH 45429
Phone (937) 395-8002

4403 Far Hills Ave
Kettering, OH 45429
Phone (937) 395-3910

1 Prestige Pl
Ste 550
Miamisburg, OH 45342
Phone (937) 752-2306

200 Medical Center Dr
Springfield, OH 45504
Phone (937) 328-8220

200 Medical Center Dr
Ste A
Springfield, OH 45504
Phone (937) 523-9480

900 Scioto St
Ste 1
Urbana, OH 43078
Phone (937) 653-4666

Organizations & group practices 2

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 2

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": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676419200000",
    "number": "1750509642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MEDICAL CENTER DR STE A",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455042688",
            "telephone_number": "937-523-9480",
            "fax_number": "937-523-9490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MEDICAL CENTER DR STE A",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455042688",
            "telephone_number": "937-523-9480",
            "fax_number": "937-523-9490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3533 Southern Blvd",
            "address_2": "Suite 5200",
            "address_purpose": "LOCATION",
            "city": "Kettering",
            "state": "OH",
            "postal_code": "454291264",
            "country_code": "US",
            "telephone_number": "937-439-6186",
            "fax_number": "937-439-9900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAESAR",
        "first_name": "MICHELLE",
        "middle_name": "AIMEE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OH",
            "license": "APRN.CNP.17178",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "309419",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0180984",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE - OHIO",
            "identifier": "APRN.CNP. 17178",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "3533 Southern Blvd",
            "address_2": "Suite 5200",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454291264",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mcaesar6014@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "3533 Southern Blvd",
            "address_2": "Suite 5200",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454291264",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Springfield, OH

Sources for this page

Verify at the official NPI Registry.