Individual provider Active NPI

Kylie B Wells, FNP-BC

  • Family Nurse Practitioner
  • Zanesville, OH
National Provider Identifier
1821470089
Registry record updated Jun 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
COA.17507-NP Issued in OH
Practice address
751 Forest Ave
Suite 300
Zanesville, OH 43701-2868
Phone
(740) 454-0804
NPI assigned
Jun 24, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2015

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 RN.381462-1 OH
Family Nurse Practitioner 363LF0000X COA.17507-NP OH Primary

Addresses

Primary practice location

751 Forest Ave
Suite 300
Zanesville, OH 43701-2868

Mailing address

751 Forest Ave
Suite 300
Zanesville, OH 43701-2868
Phone (740) 454-0804

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
I20150910001662 OH Practitioner - Nurse Practitioner 2668789447 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesis Medical Group, LLCGroup PAC ID 7719040385, 265 clinicians

Practice addresses (Care Compare)

955 Bethesda Dr
Zanesville, OH 43701-1873
Phone (740) 450-6147

Hospital & facility affiliations

  • Genesis Hospital Hospital, Zanesville, OH, CCN 360039

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN.381462-1OHMDRegistered Nurse
COA.17507-NPOHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Medical Group LLC CurrentSince Jun 28, 2015 Accepting new patients
Genesis Medical Group, LLC CurrentSince Jun 28, 2015 Accepting new patients
Cardiology Associates of Southeastern Ohio Inc. PastSince May 1, 2000 Accepting new patients

Locations

1246 Ashland Ave
Ste 204
Zanesville, OH 43701
Phone (740) 450-6167

945 Bethesda Dr
Ste 200
Zanesville, OH 43701
Phone (740) 454-4788

945 Bethesda Dr
Ste 330
Zanesville, OH 43701
Phone (740) 454-4038

751 Forest Ave
Ste 300
Zanesville, OH 43701
Phone (740) 450-3304

930 Bethesda Dr
Unit 1
Zanesville, OH 43701
Phone (740) 454-4385

955 Bethesda Dr
Ste C
Zanesville, OH 43701

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1435104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435104000000",
    "number": "1821470089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 FOREST AVE",
            "address_2": "SUITE 300",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437012868",
            "telephone_number": "740-454-0804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 FOREST AVE",
            "address_2": "SUITE 300",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437012868",
            "telephone_number": "740-454-0804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "KYLIE",
        "middle_name": "B",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-24",
        "last_updated": "2015-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.381462-1",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA.17507-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zanesville, OH

Sources for this page

Verify at the official NPI Registry.