Individual provider Active NPI

Kaelen Nothnagel, CNP

  • Primary Care Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1972016327
Registry record updated Aug 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
1075248 Issued in TX
Practice address
1441 N Beckley Ave
Dallas, TX 75203-1201
Phone
(214) 947-2385
Fax
(214) 947-2390
NPI assigned
Nov 8, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 1075248 TX Primary

Addresses

Primary practice location

1441 N Beckley Ave
Dallas, TX 75203-1201

Mailing address

1441 N Beckley Ave
Dallas, TX 75203-1201
Phone (214) 947-2385

Other practice location 1

651 W Marion Rd
Mount Gilead, OH 43338-1027
Phone (419) 946-5015

Other names 1

  • Kaelen Varney Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200227001429 OH Practitioner - Nurse Practitioner 8729415971 Reassigns benefits to 1 organization
I20220930003111 TX Practitioner - Nurse Practitioner 8729415971 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MedhealthGroup PAC ID 9931001567, 435 clinicians

Practice addresses (Care Compare)

1441 N Beckley Ave
Dallas, TX 75203-1201
Phone (214) 947-2385

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medhealth CurrentSince Sep 19, 2022 Accepting new patients
Hospitalist Medicine Physicians of Ohio, Professional Corporation Nurse Practitioner CurrentSince Nov 1, 2020 Accepting new patients
Medhealth CurrentSince Sep 19, 2022 Accepting new patients
Access Medical Group LLC PastSince Jan 15, 2020 Accepting new patients
Meritra Physicians LLC Past Accepting new patients

Locations

1 Akron General Ave
Akron, OH 44307
Phone (330) 344-5760

2420 Lake Ave
Ashtabula, OH 44004
Phone (216) 986-2919

1441 N Beckley Ave
Dallas, TX 75203
Phone (214) 712-2429

5224 S State Highway 360
Grand Prairie, TX 75052
Phone (972) 522-0691

421 E State Highway 114
Southlake, TX 76092
Phone (817) 865-4400

Interoperability endpoints

  • Direct secure messaging: knothnagel187301@dm.mhd.com

Organizations & group practices 5

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": "1510099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1972016327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 N BECKLEY AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752031201",
            "telephone_number": "214-947-2385",
            "fax_number": "214-947-2390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 N BECKLEY AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752031201",
            "telephone_number": "214-947-2385",
            "fax_number": "214-947-2390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "651 W Marion Rd",
            "address_purpose": "LOCATION",
            "city": "Mount Gilead",
            "state": "OH",
            "postal_code": "433381027",
            "country_code": "US",
            "telephone_number": "419-946-5015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOTHNAGEL",
        "first_name": "KAELEN",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-08",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "1075248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAELEN",
            "last_name": "VARNEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.