Individual provider Active NPI

Stephanie Marie Nichols, CNP

  • Family Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1750695649
Registry record updated Aug 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.11664 Issued in OH
Practice address
770 Jasonway Ave
Suite 1a
Columbus, OH 43214-4333
Phone
(614) 459-2950
Fax
(614) 459-2975
NPI assigned
Aug 3, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2016

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 APRN.CNP.11664 OH Primary

Addresses

Primary practice location

770 Jasonway Ave
Suite 1a
Columbus, OH 43214-4333

Mailing address

770 Jasonway Ave
Suite 1a
Columbus, OH 43214-4333
Phone (614) 459-2950

Other identifiers 1

IdentifierTypeStateIssuer
3102038MedicaidOH

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
I20100824000951 OH Practitioner - Nurse Practitioner 2961526249 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

4885 Olentangy River Rd
Columbus, OH 43214-1953

4895 Olentangy River Rd
Columbus, OH 43214-1185

625 Africa Rd
Westerville, OH 43082-0002

770 Jasonway Ave
Suite 1a
Columbus, OH 43214-4361
Phone (614) 459-2950

8050 E Main St
Suite 1200
Reynoldsburg, OH 43068-2575
Phone (614) 259-0923

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CNP.11664OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Modern Mental Health & Hormones LLC CurrentSince Oct 5, 2025 Accepting new patients
Central Ohio Primary Care Physicians Inc Current Accepting new patients
Psychcare Anywhere LLC Past Accepting new patients

Locations

1201 Dublin Rd
#607
Columbus, OH 43215

655 Africa Rd
Westerville, OH 43082

Interoperability endpoints

  • Direct secure messaging: snichols19269@copcp.medicity.net

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.

Hospital & facility affiliations 7

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": "1280793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470700800000",
    "number": "1750695649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 JASONWAY AVE",
            "address_2": "SUITE 1A",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432144333",
            "telephone_number": "614-459-2950",
            "fax_number": "614-459-2975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 JASONWAY AVE",
            "address_2": "SUITE 1A",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432144333",
            "telephone_number": "614-459-2950",
            "fax_number": "614-459-2975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "STEPHANIE",
        "middle_name": "MARIE",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-03",
        "last_updated": "2016-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.11664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3102038",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.