Individual provider Active NPI

Kari E. Pedersen, CNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Gahanna, OH
National Provider Identifier
1891241774
Registry record updated Sep 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
019802 Issued in OH
Practice address
437 Woodside Lake Dr
Gahanna, OH 43230-5078
Phone
(513) 368-6271
NPI assigned
Aug 30, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 019802 OH Primary

Addresses

Primary practice location

437 Woodside Lake Dr
Gahanna, OH 43230-5078

Mailing address

530 S Main St
Lima, OH 45804-1500
Phone (567) 371-4418

Other identifiers 1

IdentifierTypeStateIssuer
0185398MedicaidOH

Other names 1

  • Kari E. Graessle Former name

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
I20180308001600 OH Practitioner - Nurse Practitioner 2668733650 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Resource Center of Northwest Ohio IncGroup PAC ID 0446514673, 20 clinicians

Practice addresses (Care Compare)

530 S Main St
Lima, OH 45804-1240
Phone (419) 222-1168

Hospital & facility affiliations

  • Blanchard Valley Hospital Hospital, Findlay, OH, CCN 360095

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
019802OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Resource Center of Northwest Ohio Inc CurrentSince Sep 20, 2021 Accepting new patients

Locations

530 S Main St
Lima, OH 45804
Phone (419) 222-1168

Organizations & group practices 2

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 1

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": "1472515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1891241774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 S MAIN ST",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458041500",
            "telephone_number": "567-371-4418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "437 WOODSIDE LAKE DR",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432305078",
            "telephone_number": "513-368-6271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "KARI",
        "middle_name": "E.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-30",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "019802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0185398",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KARI",
            "last_name": "GRAESSLE",
            "middle_name": "E.",
            "credential": "CNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gahanna, OH

Sources for this page

Verify at the official NPI Registry.