MID-OHIO EMERGENCY SERVICES, LLC (NPI# 1386691780) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386691780 |
| Entity Type | Organization |
| Organization Name | MID-OHIO EMERGENCY SERVICES, LLC |
| Other Organization Name | MOES |
| Practice Address |
111 S Grant Ave Columbus OH 43215-4701 |
| Mailing Address |
1643 Nw 136th Ave Ste 100 Sunrise FL 33323-2857 |
| Practice Telephone | 6145669000 |
| Practice Fax Number | 6145668072 |
| Mailing Telephone | 8004243672 |
| Mailing Fax Number | 9543773042 |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2020-06-18 |
| Authorized Official Name | GREGORY DECKER (PRESIDENT) |
| Authorized Official Telephone | 8004243672 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | US DEPT OF LABOR | 365758500 | 01 |
| FEDERAL BLACK LUNG PROGRA | 020208900 | 01 | |
| OH | FEDERAL BLACK LUNG | 020304100 | 01 |
| OH | MEDICARE TRAVELERS RR - G | CI6323 | 01 |
| OH | 2099107 | 05 | |
| OH | US DEPT OF LABOR | 365758501 | 01 |
| OH | ANTHEM OHIO | 000000066092 | 01 |
| OH | 2099116 | 05 |
| Other Name | Type Code |
|---|---|
| MOES | Doing Business As Name - Organization |
| Street Address |
111 S GRANT AVE |
| City | COLUMBUS |
| State | OH |
| Zip Code | 43215-4701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336146075 | Edward John Weisenberger | Nurse Anesthetist, Certified Registered | 111 S Grant Ave, 3rd Fl, Columbus, OH 43215 | 2005-07-07 |
| 1114528171 | Jessica Lynn Hack | Nurse Practitioner | 111 S Grant Ave, Columbus, OH 43215-1898 | 2020-11-05 |
| 1780297424 | Lauren Entwistle | Physician Assistant | 111 S Grant Ave, Columbus, OH 43215-4701 | 2020-08-24 |
| 1427673185 | Ohiohealth Grant Medical Center | Pharmacy | 111 S Grant Ave, Columbus, OH 43215-4701 | 2020-06-09 |
| 1215557871 | Kelly Elizabeth Ventresco | Nurse Practitioner | 111 S Grant Ave, Columbus, OH 43215-1898 | 2020-04-23 |
| 1255968624 | Allison Kaye Hoynes | Student in an Organized Health Care Education/Training Program | 111 S Grant Ave, Columbus, OH 43215-4701 | 2020-03-25 |
| 1023648318 | Fardowsa O Khalif | Nurse Practitioner | 111 S Grant Ave, N/a, Columbus, OH 43215 | 2020-01-25 |
| 1174167944 | Hope Deborah Dela Vega | Physical Therapist | 111 S Grant Ave, Columbus, OH 43215-1898 | 2019-11-04 |
| 1184271553 | Gabrielle Noel Colaiacovo | Physician Assistant | 111 S Grant Ave, Columbus, OH 43215-4701 | 2019-08-21 |
| 1053979328 | Megan Elizabeth Vanlandingham | Physician Assistant | 111 S Grant Ave, Columbus, OH 43215-4701 | 2019-06-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912529496 | Ade Elisha | Counselor | 61 West Long St, Columbus, OH 43215 | 2020-05-07 |
| 1073140083 | Ryan Jeffrey Stone | Student in an Organized Health Care Education/Training Program | 393 E. Town Street, #116, Columbus, OH 43215 | 2020-03-27 |
| 1316572316 | Covermymeds Specialty Pharmacy LLC | Pharmacy | 2 Miranova Pl 10th Fl, Suite 101, Columbus, OH 43215 | 2020-03-10 |
| 1902443807 | Nicole Marie Thompson | Social Worker | Southeast, Inc., 16 W Long St, Columbus, OH 43215 | 2019-12-10 |
| 1043852858 | Rachel Therese James | Licensed Practical Nurse | 1380 Dublin Rd Suite 100, Columbus, OH 43215 | 2019-10-14 |
| 1447804737 | Remington-davis, Inc. | Specialist | 1335 Dublin Road, Suite 106a, Columbus, OH 43215 | 2019-07-25 |
| 1346892619 | Nicole Nuxol Talley | Nurse Practitioner | 1335 Dublin Rd Ste 124-d, Columbus, OH 43215 | 2019-07-16 |
| 1730650664 | Sierra N White | Marriage & Family Therapist | 399 E. Main Street, Columbus, OH 43215 | 2018-12-17 |
| 1043798937 | David Benjamin Blankenbeckley | Nurse Practitioner | 3 Nationwide Plz Ste 150, Columbus, OH 43215 | 2018-08-01 |
| 1891272795 | Tiffany Mindigo | Nurse Practitioner | 1335 Dublin Rd Ste 114e, Columbus, OH 43215 | 2018-07-24 |
| Find all providers in zip 43215 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790396984 | Chisholm Trail Urgent Care Pllc | Emergency Medicine | 11 Tsys Way, Columbus, GA 31901 | 2020-08-12 |
| 1982233953 | Zacharia A Grami | Emergency Medicine | 774 Prior Hall, 376 West 10th Avenue, Columbus, OH 43210 | 2020-04-02 |
| 1265895262 | Andrew Vang | Emergency Medicine | 4503 Glenhaven Dr, Columbus, OH 43231-5987 | 2016-03-29 |
| 1982065777 | Jack D Sherrer Jr. | Emergency Medicine | 7301 Northlake Drive, Columbus, GA 31909 | 2016-03-08 |
| 1477935393 | Chloe Sidley | Emergency Medicine | 376 W 10th Ave., 760 Prior Hall, Columbus, OH 43210 | 2015-06-27 |
| 1871975755 | Jennifer Cotton | Emergency Medicine | W 10th Ave, 760 Prior Hall, Columbus, OH 43214 | 2015-06-26 |
| 1831584606 | Chase Foy | Emergency Medicine | 376 W. 10th Ave, 774 Prior Hall, Columbus, OH 43210-1280 | 2015-03-30 |
| 1215342506 | George Edward Ashby | Emergency Medicine | 760 Prior Hall 376 W 10th Ave, Columbus, OH 43210-1240 | 2014-06-25 |
| 1376953463 | Matthew Pitzer | Emergency Medicine | 3525 Olentangy River Rd Ste 5320, Columbus, OH 43214 | 2014-04-29 |
| 1275950651 | Julia Elisabeth Ojcius | Emergency Medicine | 1447 Highland St Apt A, Columbus, OH 43201-2741 | 2014-03-24 |
| 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.