Individual provider Active NPI

Adam Tyler Kurtz, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Portsmouth, OH
National Provider Identifier
1790294460
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN.CNP.0037952 Issued in OH
Practice address
1634 11TH St
Portsmouth, OH 45662-4526
Phone
(740) 355-7102
Fax
(740) 353-3083
NPI assigned
Sep 26, 2017
Last updated
Nov 14, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN.CNP.0037952 OH Primary
Case Management Registered Nurse 163WC0400X RN.455453 OH
Psychiatric/Mental Health Registered Nurse 163WP0808X RN.455453 OH

Addresses

Primary practice location

1634 11TH St
Portsmouth, OH 45662-4526

Mailing address

1634 11TH St
Portsmouth, OH 45662-4526
Phone (740) 355-7102

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
I20241120003096 OH Practitioner - Nurse Practitioner 6507391091 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment
Group practices
Compass Community HealthGroup PAC ID 1759516693, 6 clinicians

Practice addresses (Care Compare)

1634 11TH St
Portsmouth, OH 45662-4526
Phone (740) 355-7102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0037952OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Compass Community Health Current Accepting new patients
Compass Community Health CurrentSince Oct 1, 2024 Accepting new patients
Compass Community Health Past Accepting new patients

Locations

1634 11th St
Portsmouth, OH 45662
Phone (740) 355-7102

1656 Coles Blvd
#A
Portsmouth, OH 45662
Phone (740) 355-7102

Interoperability endpoints

  • Direct secure messaging: adam.kurtz.p1@direct.compass-share.nextgenshare.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1506384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1790294460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1634 11TH ST",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456624526",
            "telephone_number": "740-355-7102",
            "fax_number": "740-355-3083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1634 11TH ST",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456624526",
            "telephone_number": "740-355-7102",
            "fax_number": "740-353-3083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURTZ",
        "first_name": "ADAM",
        "middle_name": "TYLER",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-26",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0037952",
            "primary": true
        },
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "OH",
            "license": "RN.455453",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "OH",
            "license": "RN.455453",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, OH

Sources for this page

Verify at the official NPI Registry.