Individual provider Active NPI

Eve Ciacciarelli

  • Physical Therapist
  • Columbus, OH
National Provider Identifier
1073941779
Registry record updated Oct 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
014529 Issued in OH
Practice address
6465 E Broad St
Columbus, OH 43213-1576
Phone
(614) 864-1089
NPI assigned
Oct 16, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 014529 OH Primary

Addresses

Primary practice location

6465 E Broad St
Columbus, OH 43213-1576

Mailing address

4044 Charter Oak Way
Columbus, OH 43219-6090
Phone (609) 751-3377

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230810004337 OH Practitioner - Physical Therapist in Private Practice 2163884909 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McKibben Enterprises, LLCGroup PAC ID 5698167310, 5 clinicians

Practice addresses (Care Compare)

193 W Schrock Rd
Westerville, OH 43081-2890
Phone (614) 325-5355

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
014529OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
McKibben Enterprises, LLC CurrentSince Jun 10, 2023 Accepting new patients

Locations

193 W Schrock Rd
Westerville, OH 43081
Phone (614) 325-5355

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CDEFCD/Endpoint/CDEFCD

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1381881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381881600000",
    "number": "1073941779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4044 CHARTER OAK WAY",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432196090",
            "telephone_number": "609-751-3377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6465 E BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432131576",
            "telephone_number": "614-864-1089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIACCIARELLI",
        "first_name": "EVE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-16",
        "last_updated": "2013-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "014529",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 16, 2013; 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.