Michele L Althouse, CNP

Individual provider Active NPI Family Nurse Practitioner · Newark, OH

NPI 1831483643 · NPPES record last updated Jan 24, 2018

Key facts

NPI
1831483643
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
NP12500 (OH)
Practice address
380 John St
Newark, OH 43055
Phone
(740) 281-2594
Fax
(740) 281-2699
NPI assigned
Jun 9, 2011
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20120328000542 OH Practitioner - Nurse Practitioner 5991965931

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN322779OHMDRegistered Nurse
NP12500OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians Past Accepting new patients
Promedica Central Physicians Past Accepting new patients
Radiology Inc Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN322779 OH
Family Nurse Practitioner 363LF0000X NP12500 OH Yes

Addresses

Primary practice location

380 John St
Newark, OH 43055

Mailing address

1 Seagate Ste 800
Toledo, OH 43604-1558
Phone (567) 585-1992

Other identifiers

IdentifierTypeStateIssuer
0061804MedicaidOH

Other providers in Newark, OH

All providers in Newark, OH · Family Nurse Practitioner in Ohio

Sources for this page

Verify at the official NPI Registry.