Krystal Jo Etters, RN

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

APRN.CNP.0029903 Issued in OH

Practice address

4690 Butler Rd
Roseville, OH 43777-9719

Phone

(740) 252-1934

NPI assigned

Feb 20, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Krystal Jo Rice Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Locations

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.

• Absolute Hospice, Inc.

  • Community Based Hospice Care Agency
  • North Canton, OH
  • NPI 1649694068
  Medicare reassignment NPD
• Absolute Palliative Care, Inc

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • North Canton, OH
  • NPI 1013887272
  Medicare reassignment

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

{
    "created_epoch": "1361318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1780924217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 PERINE RD",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437017641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4690 BUTLER RD",
            "city": "ROSEVILLE",
            "state": "OH",
            "postal_code": "437779719",
            "telephone_number": "740-252-1934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETTERS",
        "first_name": "KRYSTAL",
        "middle_name": "JO",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-20",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.374253",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OH",
            "license": "APRN.CNP.0029903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRYSTAL",
            "last_name": "RICE",
            "middle_name": "JO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jack Butterfield, M.D.
• Nikole Carney Daniels, ATC
• Angelica Nycole Cutright
• Melissa Marie Dillehay, LPN
• Candace Dillworth
• Extended Care Air Therapy Systems, Inc
• Genesis Healthcare System
• Lois Ann Guy
• Lauren A Hogue, PA-C
• Donna Jean Holshuer III

• Primary Care Nurse Practitioner in Roseville, OH
• Providers in Roseville, OH by specialty
• Primary Care Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.