Individual provider Active NPI

Andrea Nicole Naegele, FNP-C

  • Family Nurse Practitioner
  • Beavercreek, OH
National Provider Identifier
1972182863
Registry record updated Nov 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.0028632 Issued in OH
Practice address
725 University Blvd
Beavercreek, OH 45324-2640
Phone
(937) 245-7200
NPI assigned
Apr 7, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X LE00036103 OH
Family Nurse Practitioner 363LF0000X APRN.CNP.0028632 OH Primary

Addresses

Primary practice location

725 University Blvd
Beavercreek, OH 45324-2640

Mailing address

312 W Columbus St
West Liberty, OH 43357-9232
Phone (937) 605-4928

Other practice location 1

7760 W VOA Park Dr
West Chester Twp, OH 45069-4506
Phone (513) 563-4321

Other identifiers 1

IdentifierTypeStateIssuer
0442755MedicaidOH

Other names 1

  • Ms. Andrea Nicole Naegele Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Dayton Health Information Exchange (HIE)

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
I20260330000017 OH Order and Referring Only - Nurse Practitioner 3577962729

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

12 Cadillac Dr
Suite 300
Brentwood, TN 37027-5272

312 W Columbus St
West Liberty, OH 43357-9232

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LE00036103OHMDFamily Medicine Physician
APRN.CNP.0028632OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lima Memorial Joint Operating Company Past Accepting new patients
Hospital Care Group, P.C. Family Medicine Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1617753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1972182863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 W COLUMBUS ST",
            "city": "WEST LIBERTY",
            "state": "OH",
            "postal_code": "433579232",
            "telephone_number": "937-605-4928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 UNIVERSITY BLVD",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "453242640",
            "telephone_number": "937-245-7200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7760 W VOA Park Dr",
            "address_purpose": "LOCATION",
            "city": "West Chester Twp",
            "state": "OH",
            "postal_code": "450694506",
            "country_code": "US",
            "telephone_number": "513-563-4321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAEGELE",
        "first_name": "ANDREA",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-07",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "LE00036103",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0028632",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0442755",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Dayton",
            "affiliation": "N",
            "endpointDescription": "computer",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "725 University Blvd",
            "city": "Beavercreek",
            "state": "OH",
            "country_code": "US",
            "postal_code": "453242640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "NAEGELE",
            "middle_name": "NICOLE",
            "prefix": "MS.",
            "credential": "FNP-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Beavercreek, OH

Sources for this page

Verify at the official NPI Registry.