CENTRAL OHIO PRIMARY CARE PHYSICIANS SPECIALTY SERVICES LLC (NPI# 1104972330) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104972330 |
| Entity Type | Organization |
| Organization Name | CENTRAL OHIO PRIMARY CARE PHYSICIANS SPECIALTY SERVICES LLC |
| Practice Address |
4885 Olentangy River Rd Columbus OH 43214-1926 |
| Mailing Address |
570 Polaris Pkwy Suite 250 Westerville OH 43082-7900 |
| Practice Telephone | 6144519229 |
| Practice Fax Number | 6144510981 |
| Mailing Telephone | 6143262672 |
| Mailing Fax Number | 6143262685 |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2014-01-23 |
| Authorized Official Name | JOHN W WULF (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 6148658011 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
Allopathic & Osteopathic Physicians | ||
| N | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 207RM1200X |
Internal Medicine Specialization: Magnetic Resonance Imaging (MRI) |
Allopathic & Osteopathic Physicians | ||
| N | 2085U0001X |
Radiology Specialization: Diagnostic Ultrasound |
Allopathic & Osteopathic Physicians | ||
| N | 208100000X | Physical Medicine & Rehabilitation | Allopathic & Osteopathic Physicians | ||
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| Street Address |
4885 OLENTANGY RIVER RD |
| City | COLUMBUS |
| State | OH |
| Zip Code | 43214-1926 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730185844 | Joseph G Jacko | Internal Medicine | 4885 Olentangy River Rd, Suite 2-50, Columbus, OH 43214-1952 | 2005-06-23 |
| 1982947925 | Michael T. Dibartola | Pediatrics | 4885 Olentangy River Rd, Suite 2-10, Columbus, OH 43214-1993 | 2013-03-28 |
| 1083802854 | Monika P Jhaveri | Internal Medicine | 4885 Olentangy River Rd, Suite 1-10, Columbus, OH 43214-1952 | 2007-10-05 |
| 1083826093 | Lindsay A Wylie | Pediatrics | 4885 Olentangy River Rd, Suite 2-10, Columbus, OH 43214-1952 | 2007-05-03 |
| 1992851125 | Central Ohio Primary Care Physicians Laboratory Services, LLC | Family Medicine | 4885 Olentangy River Rd, Columbus, OH 43214-1926 | 2007-01-29 |
| 1346315819 | Wm S Rothermel Jr Md Inc | Surgery | 4885 Olentangy River Rd, Suite 230, Columbus, OH 43214 | 2006-11-21 |
| 1639279045 | Central Ohio Primary Care Physicians, Inc. | Clinical Medical Laboratory | 4885 Olentangy River Rd, Suite 1-20, Columbus, OH 43214-1926 | 2006-09-25 |
| 1003926320 | North Star Vision Center At Olentangy, L.L.C. | Optometrist | 4885 Olentangy River Rd, Columbus, OH 43214-1926 | 2006-08-30 |
| 1023059797 | Cathy A Greiwe | Family Medicine | 4885 Olentangy River Rd, Suite 110, Columbus, OH 43214-1952 | 2006-06-10 |
| 1043257835 | Tracey L Trgovac | Internal Medicine | 4885 Olentangy River Rd, Suite 110, Columbus, OH 43214-1952 | 2006-06-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275145070 | The Smile Method LLC | Dentist | 3545 Olentangy River Rd., Suite 128, Columbus, OH 43214 | 2020-08-21 |
| 1083175681 | Mahima Venkatesh Prasad | Student in an Organized Health Care Education/Training Program | 3535 Olentangy River Road Ground/yellow, Columbus, OH 43214 | 2019-03-27 |
| 1346737988 | Julie Jackson | Occupational Therapist | 214 Westwood Rd, Columbus, OH 43214 | 2018-04-19 |
| 1942703830 | A1 Nursing Solution,llc | Nursing Care | 4770 Indianola Ave Ste Ll-j, Columbus, OH 43214 | 2018-03-16 |
| 1699280024 | Darlene R Britford | Social Worker | 3770 N. High Street, Columbus, OH 43214 | 2017-12-07 |
| 1194235739 | Molly Luckner | Social Worker | 3763 N High St., Ste A, Columbus, OH 43214 | 2017-10-10 |
| 1700395357 | Deidre Monique Radford | Peer Specialist | 3770 North High St., Columbus, OH 43214 | 2017-09-27 |
| 1154844884 | Beth Balog | Pharmacist | 513 Arden Rd, Columbus, OH 43214 | 2017-07-25 |
| 1164951430 | Raad Bin Zakir Chowdhury | Student in an Organized Health Care Education/Training Program | 3595 Olentangy River Road, Columbus, OH 43214 | 2017-06-08 |
| 1841734787 | Joel Franck | Counselor | 3620 High Street, Suite 107, Columbus, OH 43214 | 2016-12-12 |
| Find all providers in zip 43214 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467964718 | Columbus Radiology Physicians LLC | Radiology | 2400 E. 17th Street, Columbus, IN 47201 | 2017-10-26 |
| 1922528595 | Advantage Imaging, LLC | Radiology | 1120 Polaris Pkwy Ste 105, Columbus, OH 43240-4042 | 2017-06-23 |
| 1710220975 | Mina S Makary | Radiology | Department of Radiology, Osu Medical Center, 395 W. 12th Ave, 4th Floor, Columbus, OH 43210 | 2013-04-05 |
| 1619236387 | Christopher Scott Davis | Radiology | 395 W 12th Ave Rm 482, Columbus, OH 43210-1267 | 2012-05-15 |
| 1144591066 | Morton I Goldstein | Radiology | 2142 Maple Bnd, Columbus, OH 43229-6809 | 2012-01-24 |
| 1447563168 | Louis Marone | Radiology | Po Box L3402, Columbus, OH 43260-0001 | 2010-07-22 |
| 1407179062 | Theresa M. March | Radiology | 4937 W Broad Street, Suite 302, Columbus, OH 43228 | 2010-03-10 |
| 1114153467 | Kerry Yolanda Cole | Radiology | 2984 Valley Creek Dr, Columbus, OH 43223-3525 | 2009-06-01 |
| 1760631105 | Frank Michael Mullinix | Radiology | 10601 W Grandview Dr, Columbus, IN 47201-8697 | 2008-09-10 |
| 1508024209 | Clinic Medical Services Company | Radiology | 1550 Kenny Rd, Columbus, OH 43212-2564 | 2008-05-29 |
| Find all providers in COLUMBUS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.