Individual provider Active NPI

Kristen Pertuset, FNP-BC

  • Family Nurse Practitioner
  • Piketon, OH
National Provider Identifier
1831515303
Registry record updated Nov 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
COA.15793-NP Issued in OH
Practice address
100 Indian Ridge Dr Ste 1
Piketon, OH 45661-9654
Phone
(740) 947-6480
Fax
(740) 947-6482
NPI assigned
Mar 8, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X COA.15793-NP OH Primary

Addresses

Primary practice location

100 Indian Ridge Dr Ste 1
Piketon, OH 45661-9654

Mailing address

100 Indian Ridge Dr Ste 1
Piketon, OH 45661-9654
Phone (740) 947-6480

Other names 1

  • Kristen Ann Lacoste Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address adena.fam.med.piketon@adena.medicity.net

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
I20150227001284 OH Practitioner - Nurse Practitioner 9638495153 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Adena Medical Group LLCGroup PAC ID 1153456579, 384 clinicians

Practice addresses (Care Compare)

100 Indian Ridge Dr
Piketon, OH 45661-9654
Phone (740) 289-1548

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
COA.15793-NPOHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Adena Medical Group LLC CurrentSince Oct 17, 2022 Accepting new patients

Locations

4437 State Route 159
Ste 125
Chillicothe, OH 45601
Phone (740) 779-4570

100 Indian Ridge Dr
Ste 1
Piketon, OH 45661
Phone (740) 947-6480

100 Indian Ridge Dr
Piketon, OH 45661
Phone (740) 289-1548

12340 State Route 104
Waverly, OH 45690
Phone (740) 941-5180

Interoperability endpoints

  • Direct secure messaging: kpertuset1074230@direct.osumc.edu

Organizations & group practices 1

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 2

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": "1394236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667779200000",
    "number": "1831515303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 INDIAN RIDGE DR STE 1",
            "city": "PIKETON",
            "state": "OH",
            "postal_code": "456619654",
            "telephone_number": "740-947-6480",
            "fax_number": "740-947-6482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 INDIAN RIDGE DR STE 1",
            "city": "PIKETON",
            "state": "OH",
            "postal_code": "456619654",
            "telephone_number": "740-947-6480",
            "fax_number": "740-947-6482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERTUSET",
        "first_name": "KRISTEN",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-08",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA.15793-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adena.fam.med.piketon@adena.medicity.net",
            "affiliation": "N",
            "address_1": "100 Indian Ridge Dr Ste 1",
            "city": "Piketon",
            "state": "OH",
            "country_code": "US",
            "postal_code": "456619654",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "LACOSTE",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Piketon, OH

Sources for this page

Verify at the official NPI Registry.