Individual provider Active NPI

Erica Jane Wolf

  • Family Nurse Practitioner
  • Cincinnati, OH
National Provider Identifier
1912415068
Registry record updated Nov 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.024338 Issued in OH
Practice address
3101 Burnet Ave
Cincinnati, OH 45229-3014
Phone
(859) 802-0759
NPI assigned
Jan 10, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X RN.425121 OH
Family Nurse Practitioner 363LF0000X APRN.CNP.024338 OH Primary

Addresses

Primary practice location

3101 Burnet Ave
Cincinnati, OH 45229-3014

Mailing address

3737 Southern Blvd Ste 4200
Kettering, OH 45429-0135
Phone (937) 294-1489

Other practice location 1

3737 Southern Blvd Ste 4200
Kettering, OH 45429-0135
Phone (937) 294-1489

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ewolf660868@direct.ketteringhealth.org
FHIR URL https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/

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
I20190612003108 OH Practitioner - Nurse Practitioner 0840523460 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kettering Independent Medical Group IncGroup PAC ID 3173710936, 699 clinicians

Practice addresses (Care Compare)

3535 Southern Blvd
Kettering, OH 45429-1221
Phone (937) 395-8646

3737 Southern Blvd
Suite 4200
Kettering, OH 45429-0135
Phone (937) 294-1489

4403 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 433-5309

4441 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 298-7751

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.34 of 100Reported as group
Quality
63.67
Promoting interoperability
100
Improvement activities
40
Cost
74.14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CNP.024338OHMDFamily Nurse Practitioner
RN.425121OHMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Kettering Independent Medical Group Inc CurrentSince Dec 29, 2022 Accepting new patients

Locations

3535 Pentagon Blvd
Ste 320
Beavercreek, OH 45431
Phone (937) 490-2270

3737 Southern Blvd
Ste 4200
Kettering, OH 45429
Phone (937) 813-7348

4403 Far Hills Ave
Kettering, OH 45429
Phone (937) 395-3910

1 Prestige Pl
Ste 550
Miamisburg, OH 45342
Phone (937) 752-2306

6147 State Route 122
Ste 110
Middletown, OH 45005
Phone (513) 260-3500

112 S Main St
Middletown, OH 45044
Phone (513) 423-0739

825 N Main St
Ste 230
Springboro, OH 45066
Phone (866) 224-9472

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 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": "1515542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605225600000",
    "number": "1912415068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 SOUTHERN BLVD STE 4200",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454290135",
            "telephone_number": "937-294-1489",
            "fax_number": "937-294-7999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 BURNET AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293014",
            "telephone_number": "859-802-0759"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3737 Southern Blvd Ste 4200",
            "address_purpose": "LOCATION",
            "city": "Kettering",
            "state": "OH",
            "postal_code": "454290135",
            "country_code": "US",
            "telephone_number": "937-294-1489",
            "fax_number": "937-294-7999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOLF",
        "first_name": "ERICA",
        "middle_name": "JANE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-10",
        "last_updated": "2020-11-13",
        "certification_date": "2020-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": "RN.425121",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.024338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ewolf660868@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "3737 Southern Blvd Ste 4200",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454290135",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "3737 Southern Blvd Ste 4200",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454290135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.