OrganizationActive
My Practitoner Family Practice
NPI 1053657098 · Family Health Clinical Nurse Specialist · Amelia, OH
Provider details
- NPI number
- 1053657098
- Entity type
- Organization
- Primary specialty
- Family Health Clinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Kathy Brock, Owner(513) 748-0874
- License
- COA.13223-NP (OH)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Detailed profile(78/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2996 State Route 132
Amelia, OH 45102-2404
Phone: (513) 748-0874
Fax: (513) 322-7989
Street-level locationGet directions
Mailing address
2996 State Route 132
Amelia, OH 45102-2404
Registry dates
- Enumerated
- 2012-12-19
- Last updated
- 2013-07-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.