Individual provider Active NPI

Nikki Michelle Kornetz, LPN

  • Licensed Practical Nurse
  • Springfield, OH
National Provider Identifier
1871896829
Registry record updated Dec 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN.125113-M-IV Issued in OH
Practice address
2814 Argonne LN S
Springfield, OH 45503-1286
Phone
(937) 408-1331
NPI assigned
Dec 14, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN.125113-M-IV OH Primary

Addresses

Primary practice location

2814 Argonne LN S
Springfield, OH 45503-1286

Mailing address

2814 Argonne LN S
Springfield, OH 45503-1286
Phone (937) 408-1331

Other names 1

  • Nikki Michelle Maurer Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PN.125113-M-IVOHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1292284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292284800000",
    "number": "1871896829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2814 ARGONNE LN S",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455031286",
            "telephone_number": "937-408-1331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2814 ARGONNE LN S",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455031286",
            "telephone_number": "937-408-1331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORNETZ",
        "first_name": "NIKKI",
        "middle_name": "MICHELLE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-14",
        "last_updated": "2010-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN.125113-M-IV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NIKKI",
            "last_name": "MAURER",
            "middle_name": "MICHELLE",
            "credential": "LPN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Springfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.