Kaitlin Marie Mack, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN.CNP.021460 Issued in OH

Practice address

800 McConnell Rd
Columbus, OH 43214-3463

Phone

(614) 566-5019

NPI assigned

Sep 5, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kaitlin Marie Clark 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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ohiohealth CorporationGroup PAC ID 6305758426, 2,295 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Riverside Methodist Hospital Hospital, Columbus, OH, CCN 360006

Merit-based Incentive Payment System (MIPS)

Final score

80.04 of 100Reported as group

Quality

58.67

Promoting interoperability

98

Improvement activities

40

Cost

76.46

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

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.

• Ohiohealth Corporation

  • Family Medicine Physician
  • Columbus, OH
  • NPI 1578545273
  Medicare reassignment Care Compare group NPD
• Ohiohealth Corporation

  • Anesthesiology Physician
  • Columbus, OH
  • NPI 1407292105
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ohiohealth Corporation

  • General Acute Care Hospital
  • Columbus, OH
  • NPI 1467484972
  Care Compare affiliation
• Ohiohealth Corporation

  • Clinical Medical Laboratory
  • Columbus, OH
  • NPI 1710916945

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1504569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504569600000",
    "number": "1790203370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 S OLD 3C HWY",
            "city": "GALENA",
            "state": "OH",
            "postal_code": "430219518",
            "telephone_number": "440-864-5120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MCCONNELL RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432143463",
            "telephone_number": "614-566-5019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "KAITLIN",
        "middle_name": "MARIE",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-05",
        "last_updated": "2017-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.021460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLIN",
            "last_name": "CLARK",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Aaron Christopher Mack, MD
• Carla Jean Mack, O.D.
• Donald Owen Mack, MD
• Dymond Mack
• Gregory Thomas Mack, ACE-CMES
• Karen Marie Mack, RPH
• Keysha Mack
• Nathaniel Mack, MD
• Trevor Hayden Mack, CRNA
• Kaleigh Michelle Mackay, LSW

• Family Nurse Practitioner in Columbus, OH
• Providers in Columbus, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.