Integrated Family Medicine, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35-08-0529 Issued in OH

Legal business name

INTEGRATED FAMILY MEDICINE, INC.

Practice address

4701 Olentangy River Rd
Suite 1
Columbus, OH 43214-1950

Phone

(614) 818-1477

Fax

(614) 642-0807

NPI assigned

May 5, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Winnie Moazampour, M.D.

Title

Owner

Phone

(614) 818-1477

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366848000000",
    "number": "1003864323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 BRADENTON AVE",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430177515",
            "telephone_number": "614-793-1980",
            "fax_number": "614-793-1985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 OLENTANGY RIVER RD",
            "address_2": "SUITE 1",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432141950",
            "telephone_number": "614-818-1477",
            "fax_number": "614-642-0807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED FAMILY MEDICINE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2013-04-25",
        "status": "A",
        "authorized_official_last_name": "MOAZAMPOUR",
        "authorized_official_first_name": "WINNIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "614-818-1477",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35-08-0529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2345215",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.