Individual provider Active NPI

Stephanie Lynne Kistler, FNP-C

  • Nurse Practitioner
  • Westerville, OH
National Provider Identifier
1801326434
Registry record updated Oct 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
020887 Issued in OH
Practice address
9200 Worthington Rd
Westerville, OH 43082-8823
Phone
(330) 388-6323
NPI assigned
Jun 15, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 390798 OH
Nurse Practitioner 363L00000X 020887 OH Primary

Addresses

Primary practice location

9200 Worthington Rd
Westerville, OH 43082-8823

Mailing address

2709 Fairview Ave SE
Warren, OH 44484-3210
Phone (330) 980-2095

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
I20171005001824 OH Practitioner - Nurse Practitioner 9638444326 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
390798OHMDRegistered Nurse
020887OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Traditions Hospice of Highland Heights, LLC CurrentSince Jun 28, 2021 Accepting new patients
Traditions Hospice of Highland Heights, LLC CurrentSince Jun 28, 2021 Accepting new patients

Locations

677 Alpha Dr
Ste H
Highland Hgts, OH 44143
Phone (440) 385-2736

6840 Carothers Pkwy
Ste 550
Franklin, TN 37067

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1497484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507852800000",
    "number": "1801326434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2709 FAIRVIEW AVE SE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444843210",
            "telephone_number": "330-980-2095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 WORTHINGTON RD",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430828823",
            "telephone_number": "330-388-6323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISTLER",
        "first_name": "STEPHANIE",
        "middle_name": "LYNNE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-15",
        "last_updated": "2017-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "390798",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "020887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westerville, OH

Sources for this page

Verify at the official NPI Registry.