NPIMap

Organization Active NPI

Personal MD, LLC

  • Specialist
  • New Albany, OH
National Provider Identifier
1023231602
Registry record updated Jan 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
35-045924 Issued in OH
Legal business name
PERSONAL MD, LLC
Practice address
5121 Forest Drive
Suite D
New Albany, OH 43054-7102
Phone
(614) 933-9100
Fax
(614) 933-9103
NPI assigned
Apr 11, 2007
Last updated
Jan 31, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2013

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

Authorized official

Name
Deborah Milks
Title
Vice President
Phone
(614) 933-9100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 35-045924 OH Primary

Addresses

Primary practice location

5121 Forest Drive
Suite D
New Albany, OH 43054-7102

Mailing address

5121 Forest Drive
Suite D
New Albany, OH 43054-7102
Phone (614) 933-9100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070109000198 OH Part B Supplier - Clinic/Group Practice 0648270017 Receives reassigned benefits from 5 practitioners
Practice locations: Columbus, OH; Delaware, OH; New Albany, OH; Reynoldsburg, OH

National Provider Directory

National Provider Directory
Tax ID family
Personal MD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

775 E Johnstown Rd
Gahanna, OH 43230
Phone (614) 216-8818

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/4869/brand/1/csg/1/fhir/r4

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": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359590400000",
    "number": "1023231602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5121 FOREST DRIVE",
            "address_2": "SUITE D",
            "city": "NEW ALBANY",
            "state": "OH",
            "postal_code": "430547102",
            "telephone_number": "614-933-9100",
            "fax_number": "614-933-9103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5121 FOREST DRIVE",
            "address_2": "SUITE D",
            "city": "NEW ALBANY",
            "state": "OH",
            "postal_code": "430547102",
            "telephone_number": "614-933-9100",
            "fax_number": "614-933-9103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONAL MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2013-01-31",
        "status": "A",
        "authorized_official_last_name": "MILKS",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "614-933-9100"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OH",
            "license": "35-045924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Albany, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.