Provider Demographics
NPI: | 1831173046 |
---|---|
Name: | KAISI, NADIA K (MD) |
Entity type: | Individual |
Prefix: | DR |
First Name: | NADIA |
Middle Name: | K |
Last Name: | KAISI |
Suffix: | |
Gender: | F |
Credentials: | MD |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | ONE GI CREDENTIALING DEPARTMENT |
Mailing Address - Street 2: | PO BOX 381468 |
Mailing Address - City: | GERMANTOWN |
Mailing Address - State: | TN |
Mailing Address - Zip Code: | 38183-1468 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1299 INDUSTRIAL PKWY N STE 110 |
Practice Address - Street 2: | |
Practice Address - City: | BRUNSWICK |
Practice Address - State: | OH |
Practice Address - Zip Code: | 44212-6366 |
Practice Address - Country: | US |
Practice Address - Phone: | 330-225-6468 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2005-12-01 |
Last Update Date: | 2025-02-28 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
OH | 35053627 | 207ZP0007X, 207ZF0201X, 207ZH0000X, 207ZI0100X, 207ZM0300X, 207ZN0500X, 207ZP0101X, 207ZP0104X, 207ZP0213X, 207ZP0102X, 207ZP0105X, 207ZC0006X, 207ZC0500X, 207ZD0900X, 207ZB0001X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207ZP0102X | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
No | 207ZP0007X | Allopathic & Osteopathic Physicians | Pathology | Molecular Genetic Pathology |
No | 207ZF0201X | Allopathic & Osteopathic Physicians | Pathology | Forensic Pathology |
No | 207ZH0000X | Allopathic & Osteopathic Physicians | Pathology | Hematology |
No | 207ZI0100X | Allopathic & Osteopathic Physicians | Pathology | Immunopathology |
No | 207ZM0300X | Allopathic & Osteopathic Physicians | Pathology | Medical Microbiology |
No | 207ZN0500X | Allopathic & Osteopathic Physicians | Pathology | Neuropathology |
No | 207ZP0101X | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology |
No | 207ZP0104X | Allopathic & Osteopathic Physicians | Pathology | Chemical Pathology |
No | 207ZP0213X | Allopathic & Osteopathic Physicians | Pathology | Pediatric Pathology |
No | 207ZP0105X | Allopathic & Osteopathic Physicians | Pathology | Clinical Pathology/Laboratory Medicine |
No | 207ZC0006X | Allopathic & Osteopathic Physicians | Pathology | Clinical Pathology |
No | 207ZC0500X | Allopathic & Osteopathic Physicians | Pathology | Cytopathology |
No | 207ZD0900X | Allopathic & Osteopathic Physicians | Pathology | Dermatopathology |
No | 207ZB0001X | Allopathic & Osteopathic Physicians | Pathology | Blood Banking & Transfusion Medicine |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
OH | 0164334 | Medicaid | |
OH | 0164334 | Medicaid | |
OH | KA0780922 | Medicare ID - Type Unspecified | |
OH | AL0780923 | Medicare PIN | |
OH | KA0780923 | Medicare PIN | |
OH | P00823790 | Medicare PIN |