RODELISA DOUGLAS (CNP) – Family Nurse Practitioner, NPI 1134997257

RODELISA DOUGLAS (CNP) is a healthcare provider. based in Columbus, Ohio. specializing in NURSE PRACTITIONER. They hold the professional credentials CNP. They hold a License No. 0035121 (OH). The NPI Number for RODELISA DOUGLAS (CNP) is 1134997257

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
RODELISA DOUGLAS (CNP)
NPI
1134997257
Phone
(614) 381-4150
Address
3549 ALBERTA ST
Enumeration Date
18 December 2023
Last Update Date
4 October 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6143434783
Graduation Year
2023 (3 years ago)
PAC ID
5890139703
Group Practice PAC ID
7719087584
Professional Enrollment ID
I20240220000736
Address ID
OH431251006GR6011XRDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

14,984 NURSE PRACTITIONER in OH

Provider Addresses for RODELISA DOUGLAS (CNP)

  • 3549 ALBERTA ST

    COLUMBUS, OH 432281401

    Phone: (614) 381-4150

    Type: Mailing

  • 1585 GEORGESVILLE SQUARE DR

    COLUMBUS, OH 432283777

    Phone: (614) 335-0030

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-02-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240220000736INurse PractitionerOHTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 43228)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7719087584View full group profile

Reviews

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Frequently asked questions

How is RODELISA DOUGLAS (CNP) identified in CMS data?
CMS-hosted NPPES data lists RODELISA DOUGLAS (CNP) with NPI 1134997257.
Can I rely on RODELISA DOUGLAS (CNP) being an active provider?
As of the registry snapshot, RODELISA DOUGLAS (CNP) is marked active.
What is RODELISA DOUGLAS (CNP)'s specialty?
The listing groups RODELISA DOUGLAS (CNP) with Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where is RODELISA DOUGLAS (CNP) based?
RODELISA DOUGLAS (CNP) is tied to Columbus, Ohio in the data we show; additional addresses may exist on the full record.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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