COLUMBUS PHYSICIAN RESOURCES INC (NPI# 1447378567) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447378567 |
| Entity Type | Organization |
| Organization Name | COLUMBUS PHYSICIAN RESOURCES INC |
| Other Organization Name | FOURTH AND DIAMOND MEDICAL CLINIC |
| Practice Address |
380 Cline Ave Ste 1 Mansfield OH 44907-1056 |
| Practice Telephone | 4195715290 |
| Practice Fax Number | 4195220998 |
| Mailing Telephone | 4195715290 |
| Mailing Fax Number | 4195220998 |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2020-02-10 |
| Authorized Official Name | DR. PAUL RITENOUR (DO) |
| Authorized Official Telephone | 4195715290 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | ANTHEM BCBS OF OH | 000000122735 | 01 |
| OH | 2075276 | 05 |
| Other Name | Type Code |
|---|---|
| Fourth and Diamond Medical Clinic | Doing Business As Name - Organization |
| Street Address |
380 CLINE AVE STE 1 |
| City | MANSFIELD |
| State | OH |
| Zip Code | 44907-1056 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780226092 | Ritenour Medical LLC | Clinic/Center | 380 Cline Ave Ste 1, Mansfield, OH 44907-1056 | 2019-10-09 |
| 1811543671 | Ohio Opiate Recovery | General Practice | 380 Cline Ave Ste 1, Mansfield, OH 44907-1056 | 2019-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053932434 | Kerri Nichole Tolliver | Licensed Practical Nurse | Mansfield Comprehensive Treatment Center, 475 Lexington Ave, Mansfield, OH 44907 | 2020-04-27 |
| 1790325371 | Gabrielle Smith | Licensed Practical Nurse | 707 Scholl Rd, Mansfield, OH 44907 | 2020-01-10 |
| 1912544982 | Heidi L Mathews | Behavior Technician | 270 Sterkel Blvd., Mansfield, OH 44907 | 2019-12-09 |
| 1851942254 | Misty J Kline | Licensed Practical Nurse | 707 Scholl Rd., Mansfield, OH 44907 | 2019-09-26 |
| 1528533320 | Ohio Treatment Center, LLC | Clinic/Center | 475 Lexington Ave., Mansfield, OH 44907 | 2018-10-08 |
| 1750898722 | Hannah Rose Hardin | Behavior Technician | 1033 Larchwood R, Mansfield, OH 44907 | 2017-12-29 |
| 1932548856 | Jessica Alexis Taylor | Counselor | 641 Scholl Rd., Mansfield, OH 44907 | 2013-06-25 |
| 1336495258 | Sonal Sinha | Psychiatry & Neurology | 341 Cline Ave Ste 1, Mansfield, OH 44907 | 2012-07-29 |
| 1427321579 | Tara Kightlinger | Community Health Worker | 442 Brenda Dr, Mansfield, OH 44907 | 2012-02-21 |
| 1649557620 | William Scott Olar | Chiropractor | 1179 Lexington Ave, Mansfield, OH 44907 | 2011-11-04 |
| Find all providers in zip 44907 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518494723 | Mansfield Orthopedic Associates | Specialist | 4503 Blue Grass Ct, Mansfield, TX 76063-1877 | 2017-05-18 |
| 1740681030 | Amy Burns | Specialist | 1291 Lexwood Rd, Mansfield, OH 44907-2923 | 2014-09-06 |
| 1376844456 | Mark A. Bishara, Md, Pa | Specialist | 550 N Walnut Creek Dr, Suite 120, Mansfield, TX 76063-3223 | 2010-11-05 |
| 1871820423 | Breast Diagnostics, Pa | Specialist | 1750 Broad Park Cir S, Suite 300, Mansfield, TX 76063-7822 | 2009-11-03 |
| 1730335076 | David R Williams | Specialist | 1020 Chasemore Ct, Mansfield, TX 76063-2654 | 2008-08-18 |
| 1720259104 | Mid-ohio Neurosurgical Care, Inc. | Specialist | 39 Wood St, Mansfield, OH 44903-2210 | 2008-03-13 |
| 1942394309 | Eye Surgery Consultants Inc. | Specialist | 240 West Cook Road, Mansfield, OH 44907 | 2006-10-02 |
| 1124128491 | Alfred Granson Jr. | Specialist | 70 Madison Rd, Mansfield, OH 44905-2831 | 2006-09-25 |
| 1982623583 | Charles H Shaw | Specialist | 370 Cline Avenue, Mansfield, OH 44907 | 2006-07-18 |
| 1851337018 | Helen Malone | Specialist | 250 East St, Mansfield, MA 02048-2526 | 2006-06-22 |
| Find all providers in MANSFIELD | ||||
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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.