COLUMBUS CHRONIC CARE MEDICAL CENTER LLC (NPI# 1295122521) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295122521 |
| Entity Type | Organization |
| Organization Name | COLUMBUS CHRONIC CARE MEDICAL CENTER LLC |
| Practice Address |
506 Mccutcheon Rd Gahanna OH 43230-5001 |
| Mailing Address |
5300 Bright Sun Ct Las Vegas NV 89130-3728 |
| Practice Telephone | 6144968420 |
| Mailing Telephone | (614) 496-8420 |
| Enumeration Date | 2015-04-24 |
| Last Update Date | 2018-03-17 |
| Authorized Official Name | MULLLISSA CHILDRESS (CEO) |
| Authorized Official Telephone | 6144968420 |
| Authorized Official Credential | FNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities | ||
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
16446-NP | OH | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0129662 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5300 Bright Sun Ct, Las Vegas, NV 891303728 | (614) 496-8420 |
| Street Address |
506 MCCUTCHEON RD |
| City | GAHANNA |
| State | OH |
| Zip Code | 43230-5001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013518695 | Adonna Fuller | Technician | 14o Imperial Drive, Apt 120, Gahanna, OH 43230 | 2020-11-02 |
| 1407471733 | Brent Flory | Counselor | 425 South Hamilton, Gahanna, OH 43230 | 2020-06-12 |
| 1245865252 | Amy Marie Cosma | Registered Nurse | 750 Cross Pointe Road, Suite D, Gahanna, OH 43230 | 2020-03-10 |
| 1447718010 | Yolanda Renee Davis | Case Manager/Care Coordinator | 1490 E Main St., Columbus, OH 43230 | 2019-03-03 |
| 1699261537 | Cap City Supported Living & Homecare Services, LLC | Home Health | 2305 South Hamilton Road, Suite 216, Columbus, OH 43230 | 2018-07-03 |
| 1467957183 | Kendra Marie Peterson | Specialist/Technologist | 1011 Arcaro Drive, Gahanna, OH 43230 | 2018-03-26 |
| 1467956805 | Beatrice Njeri Gachoro | Registered Nurse | 4484 Shady Blossom Ln, Columbus, OH 43230 | 2018-03-21 |
| 1760900211 | Centra Home Health Care, LLC | Home Health | 4745 Legare Ln, Columbus, OH 43230 | 2017-09-05 |
| 1386164325 | Ziad Al Hennawi | Dentist | 4034 Morse Rd, Columbus, OH 43230 | 2017-06-21 |
| 1336675503 | Fresenius Medical Care New Albany, LLC | Clinic/Center | 991 E Johnstown Rd, Gahanna, OH 43230 | 2017-05-10 |
| Find all providers in zip 43230 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588270722 | Jaime Spedale | Nurse Practitioner | 562 Laurel Ridge Dr, Gahanna, OH 43230-2100 | 2020-09-22 |
| 1740808468 | Alexa Teresa Csepe | Nurse Practitioner | 959 E Johnstown Rd, Gahanna, OH 43230-1851 | 2020-07-09 |
| 1770039182 | Kristine Marie Adkinson | Nurse Practitioner | 530 Humboldt Ct, Gahanna, OH 43230-5094 | 2016-08-27 |
| 1033195342 | Rhonda E. Thompson | Nurse Practitioner | 60 N Stygler Rd, Gahanna, OH 43230-2435 | 2005-12-19 |
| 1619581162 | Carla Ledbetter | Nurse Practitioner | 140 Mill St Ste B, Gahanna, OH 43230-6509 | 2020-09-02 |
| 1598378580 | Ashley Marie Williamson | Nurse Practitioner | 60 N Stygler Rd, Gahanna, OH 43230-2435 | 2020-08-28 |
| 1659984961 | Christine Stallings | Nurse Practitioner | 140 Mill St Ste B, Gahanna, OH 43230-6509 | 2020-08-26 |
| 1003426818 | Alexandra Janasov | Nurse Practitioner | 60 N Stygler Rd, Gahanna, OH 43230-2435 | 2020-08-06 |
| 1326657099 | Angie Kim | Nurse Practitioner | 60 N Stygler Rd, Gahanna, OH 43230-2435 | 2020-07-28 |
| 1174180632 | Alicia Philip | Nurse Practitioner | 701 Tech Center Dr Ste 100, Gahanna, OH 43230-1987 | 2019-05-21 |
| Find all providers in GAHANNA | ||||
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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.