NPIMap

Organization Active NPI

Mid Ohio Renal Disease and Hypertension Specialist, Inc.

  • Nephrology Physician
  • Columbus, OH
National Provider Identifier
1013017417
Registry record updated Jun 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
MID OHIO RENAL DISEASE AND HYPERTENSION SPECIALIST, INC.
Practice address
777 West State Street
Suite 502
Columbus, OH 43222
Phone
(614) 228-4018
Fax
(614) 228-4237
NPI assigned
Sep 25, 2006
Last updated
Jun 6, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2008

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

Authorized official

Name
Virginia Long
Title
Office Manager
Phone
(727) 287-6300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

777 West State Street
Suite 502
Columbus, OH 43222

Mailing address

P.O. Box 711996
Cincinnati, OH 45271-1996
Phone (727) 287-6300

Other identifiers 1

IdentifierTypeStateIssuer
2389982MedicaidOH

National Provider Directory

National Provider Directory

Locations

777 W State St
Ste 502
Columbus, OH 43222
Phone (614) 228-4018

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212710400000",
    "number": "1013017417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 711996",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452711996",
            "telephone_number": "727-287-6300",
            "fax_number": "727-287-6306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 WEST STATE STREET",
            "address_2": "SUITE 502",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "43222",
            "telephone_number": "614-228-4018",
            "fax_number": "614-228-4237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID OHIO RENAL DISEASE AND HYPERTENSION SPECIALIST, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2008-06-06",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "VIRGINIA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "727-287-6300"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2389982",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2008; 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.