Basic Information
Provider Information
NPI: 1215169487
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CADY
FirstName: KEVIN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: C.N.P.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
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Mailing Information
Address1: 575 COPELAND MILL RD
Address2: SUITE 1D
City: WESTERVILLE
State: OH
PostalCode: 430818977
CountryCode: US
TelephoneNumber: 6147940481
FaxNumber: 6147943711
Practice Location
Address1: 10330 SAWMILL PKWY
Address2: SUITE 300
City: POWELL
State: OH
PostalCode: 430657790
CountryCode: US
TelephoneNumber: 6149239200
FaxNumber: 6147943711
Other Information
ProviderEnumerationDate: 08/20/2009
LastUpdateDate: 08/20/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000XCOA.10882-NPOHY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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