Omnia Medical Group LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

OMNIA MEDICAL GROUP LLC

Practice address

65 Highview Blvd Ste 101a
Columbus, OH 43207-6065

Phone

(614) 587-7778

Fax

(740) 212-8808

NPI assigned

Mar 2, 2023

Organization subpart

No

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

Authorized official

Name

Ashley Renee Brannan, DNP, APRN, FNP-CNPI 1407354012

Title

Ceo/Family Nurse Practitioner

Phone

(614) 587-7778

Specialties & licenses 11

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ashley Renee Brannan, CNP

  • Family Nurse Practitioner
  • Columbus, OH
  • NPI 1407354012
  Medicare reassignment Authorized official
• Melinda Michelle Brannan

  • Addiction (Substance Use Disorder) Counselor
  • Columbus, OH
  • NPI 1588557789
  Medicare reassignment NPD
• Lonzie Willard Brannan

  • Addiction (Substance Use Disorder) Counselor
  • Columbus, OH
  • NPI 1134012339
  NPD (past)

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

{
    "created_epoch": "1677715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735776000000",
    "number": "1073212627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 HIGHVIEW BLVD STE 101A",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432076065",
            "telephone_number": "614-587-7778",
            "fax_number": "740-212-8808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 HIGHVIEW BLVD STE 101A",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432076065",
            "telephone_number": "614-587-7778",
            "fax_number": "740-212-8808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMNIA MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-02",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A",
        "authorized_official_last_name": "BRANNAN",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "CEO/FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "614-587-7778",
        "authorized_official_credential": "DNP, APRN, FNP-C"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Research",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0308873",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Columbus, OH
• Providers in Columbus, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.