Southwestern Recovery Center, LLC
A Medicare group practice based in Waverly, OH: 3 NPIs enrolled under one PECOS associate control ID (PAC ID 5294095956), with 14 clinicians.
Medicare enrollment
Medicare enrollment files- PAC ID
- 5294095956
- Provider type
- Part B Supplier - Clinic/Group Practice
- Enrolled in
- OH
- Enrollments
- 1
- Group size
- 6 clinicians
- Medicare assignment
- May accept Medicare assignment
- Practice locations
- 6
Enrollment records 1
| Enrollment ID | State | Provider type | NPI |
|---|---|---|---|
| O20180129001817 | OH | Part B Supplier - Clinic/Group Practice | 1295241933 |
NPIs in this group 3
NPPES NPI RegistryThese NPI records belong to the same enrolled organization. Each has its own page.
-
Southwestern Recovery Center, LLC
- Family Medicine Physician
- Columbus, OH
- NPI 1295241933
-
Southwestern Recovery Center, LLC
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Grove City, OH
- NPI 1245824788
-
Southwestern Recovery Center, LLC
- Substance Use Disorder Rehabilitation Clinic/Center
- Grove City, OH
- NPI 1427642966
Practice locations
- Columbus, OH2
- Waverly, OH2
- Grove City, OH1
- The Plains, OH1
Clinicians 14
Clinicians who reassign their Medicare benefits to this group (14) or whom Care Compare lists as members (6).
-
Heather Leigh Cullen
- Physician Assistant
- Travelers Rest, SC
- NPI 1336506690
-
Jennifer Lynne Datta, N.P.
- Acute Care Nurse Practitioner
- Delaware, OH
- NPI 1083676969
-
Anthony R Derrico, D.O.
- Psychiatry Physician
- Athens, OH
- NPI 1609886993
-
Kevin Joseph Donlon, M.D.
- Addiction Medicine (Preventive Medicine) Physician
- Columbus, OH
- NPI 1316209018
-
Dolores Duncan, PMHNP
- Psychiatric/Mental Health Nurse Practitioner
- Warren, OH
- NPI 1861042244
-
Jamie Lynn Elenz, APRN, FNP-BC
- Family Nurse Practitioner
- Niles, OH
- NPI 1316583792
-
Rachael N. Haines, PA-C
- Physician Assistant
- Columbus, OH
- NPI 1629584230
-
Lata Koneru, M.D
- Internal Medicine Physician
- Dublin, OH
- NPI 1881654945
-
Kevin Kuisel, CNP
- Acute Care Nurse Practitioner
- Columbus, OH
- NPI 1770064461
-
Letisha E Leach, FNP-BC, PMHNP-BC
- Psychiatric/Mental Health Nurse Practitioner
- Baltimore, OH
- NPI 1063656239
-
Amy R McCaul, FNP
- Family Nurse Practitioner
- Marion, OH
- NPI 1982168944
-
Vernon D Reynolds, D.O.
- Anesthesiology Physician
- Columbus, OH
- NPI 1174600852
-
Angel L Villanueva Jr., MD
- Psychiatry Physician
- Columbus, OH
- NPI 1255370714
-
Ashley White
- Family Nurse Practitioner
- Columbus, OH
- NPI 1457817975
Sources for this page
- Medicare Fee-For-Service Public Provider Enrollment: the enrollments, PAC ID, practice locations and benefit reassignments.
- Care Compare Doctors and Clinicians: group membership, group size and the name CMS shows patients.
- NPPES NPI Registry: the names and addresses of the NPIs above.