Individual provider Active NPI

Nicole A Link, NP-C

  • Family Nurse Practitioner
  • Saint Marys, OH
National Provider Identifier
1841582053
Registry record updated Apr 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.12427 Issued in OH
Practice address
1140 S Knoxville Ave Ste a
Saint Marys, OH 45885-2609
Phone
(419) 394-9959
Fax
(419) 394-0255
NPI assigned
May 5, 2011
Last updated
Apr 16, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.12427 OH Primary
Registered Nurse 163W00000X 347337 OH

Addresses

Primary practice location

1140 S Knoxville Ave Ste a
Saint Marys, OH 45885-2609

Mailing address

200 Saint Clair Ave
Saint Marys, OH 45885-2400
Phone (419) 300-1129

Other identifiers 3

IdentifierTypeStateIssuer
0052241MedicaidOH
9934723OtherOHGROUP MEDICARE PTAN
1184652539OtherOHGROUP NPI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address nicolelink@glhs.allscriptsdirect.net
Direct Messaging Address nicolelink@glhs.allscriptsdirect.net Health Information Exchange (HIE)

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
I20110930000273 OH Practitioner - Nurse Practitioner 8820260540 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Wright State University Boonshoft School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
JTDM Family Practice LLCGroup PAC ID 2163415837, 48 clinicians

Practice addresses (Care Compare)

1140 S Knoxville Ave
Suite a
Saint Marys, OH 45885-2609
Phone (419) 394-9959

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.44 of 100Reported as group
Quality
78
Promoting interoperability
96
Improvement activities
40
Cost
76.79

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
347337OHMDRegistered Nurse
APRN.CNP.12427OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
JTDM Family Practice LLC Registered Nurse CurrentSince Aug 15, 2011 Accepting new patients
Orthopaedic Institute of Ohio, Inc. Past Accepting new patients
Lima Memorial Joint Operating Company PastSince Aug 15, 2011 Accepting new patients
Joint Township District Memorial Hospital Past Accepting new patients

Locations

4463 State Route 66
Ste A
Minster, OH 45865
Phone (419) 628-3821

1040 Hager St
Saint Marys, OH 45885
Phone (419) 394-9959

1140 S Knoxville Ave
Ste A
Saint Marys, OH 45885
Phone (419) 394-9959

200 Saint Clair Ave
Saint Marys, OH 45885
Phone (419) 394-3387

Interoperability endpoints

  • Direct secure messaging: nicolelink@glhs.allscriptsdirect.net

Organizations & group practices 4

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.

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": "1304553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618531200000",
    "number": "1841582053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 SAINT CLAIR AVE",
            "city": "SAINT MARYS",
            "state": "OH",
            "postal_code": "458852400",
            "telephone_number": "419-300-1129",
            "fax_number": "419-394-0255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 S KNOXVILLE AVE STE A",
            "city": "SAINT MARYS",
            "state": "OH",
            "postal_code": "458852609",
            "telephone_number": "419-394-9959",
            "fax_number": "419-394-0255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINK",
        "first_name": "NICOLE",
        "middle_name": "A",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-05",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.12427",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "347337",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0052241",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE PTAN",
            "identifier": "9934723",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1184652539",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nicolelink@glhs.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "1040 Hager St",
            "city": "Saint Marys",
            "state": "OH",
            "country_code": "US",
            "postal_code": "458852421",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nicolelink@glhs.allscriptsdirect.net",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1140 S Knoxville Ave Ste A",
            "city": "Saint Marys",
            "state": "OH",
            "country_code": "US",
            "postal_code": "458852609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Marys, OH

Sources for this page

Verify at the official NPI Registry.