Individual provider Active NPI

Nicole Kathleen Taylor Ruark, APRN, FNP-C

  • Family Nurse Practitioner
  • Middletown, OH
National Provider Identifier
1912569625
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.024789 Issued in OH
Practice address
200 Medical Center Dr Ste 325
Middletown, OH 45005-5178
Phone
(513) 705-4762
NPI assigned
Jul 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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 APRN.CNP.024789 OH Primary

Addresses

Primary practice location

200 Medical Center Dr Ste 325
Middletown, OH 45005-5178

Mailing address

200 Medical Center Dr Ste 325
Middletown, OH 45005-5178
Phone (513) 705-4762

Other names 1

  • Miss Nicole Kathleen Taylor 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
I20191004000416 OH Practitioner - Nurse Practitioner 2365773421 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Health Specialists IncGroup PAC ID 5597708594, 576 clinicians

Practice addresses (Care Compare)

2300 Miami Valley Dr
Suite 550
Centerville, OH 45459-1298
Phone (937) 208-4200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.38 of 100Reported as group
Quality
66.25
Promoting interoperability
100
Improvement activities
40
Cost
71.69

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CNP.024789OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Health Specialists Inc CurrentSince Dec 9, 2019 Accepting new patients
Premier Health Specialists Inc CurrentSince Dec 9, 2019 Accepting new patients
Premier Heart Associates, Inc Past Accepting new patients

Locations

2300 Miami Valley Dr
Ste 550
Dayton, OH 45459
Phone (937) 438-7500

30 E Apple St
#6258
Dayton, OH 45409
Phone (937) 208-5300

1 Medical Center Dr
Middletown, OH 45005
Phone (513) 424-2111

200 Medical Center Dr
Ste 325
Middletown, OH 45005
Phone (513) 705-4762

3170 Kettering Blvd
Bldg B
Moraine, OH 45439
Phone (937) 991-3187

450 N Hyatt St
Ste 304
Tipp City, OH 45371
Phone (937) 832-4773

Organizations & group practices 3

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": "1562025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1912569625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MEDICAL CENTER DR STE 325",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450055178",
            "telephone_number": "513-705-4762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MEDICAL CENTER DR STE 325",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450055178",
            "telephone_number": "513-705-4762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUARK",
        "first_name": "NICOLE",
        "middle_name": "KATHLEEN TAYLOR",
        "name_prefix": "Mrs.",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-02",
        "last_updated": "2023-11-07",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.024789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "TAYLOR",
            "middle_name": "KATHLEEN",
            "prefix": "MISS",
            "credential": "APRN, FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Middletown, OH

Sources for this page

Verify at the official NPI Registry.