Organization Active NPI

Calvary Family Practice and Mental Health Services LLC

Doing business as Calvary Family and Mental Health Services

  • Psychiatric/Mental Health Nurse Practitioner
  • Pickerington, OH
National Provider Identifier
1083491419
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
CALVARY FAMILY PRACTICE AND MENTAL HEALTH SERVICES LLC
Doing business as
Calvary Family and Mental Health Services
Practice address
105 Egret CT
Pickerington, OH 43147-3403
Phone
(740) 415-6416
Fax
(614) 321-4161
NPI assigned
Sep 11, 2023
Last updated
Sep 2, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Authorized official

Name
Magdalene I Edo, FNP/PMHNP-BCNPI 1093088221
Title
Certified Nurse Practitioner
Phone
(740) 415-6416

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU Primary

Addresses

Primary practice location

105 Egret CT
Pickerington, OH 43147-3403

Mailing address

341 S 3Rd St
Columbus, OH 43215-5463

Other practice location 1

341 S 3rd St
Columbus, OH 43215-5463
Phone (614) 783-0405

Other names 1

  • Calvary Family and Mental Health Services Doing business as

National Provider Directory

National Provider Directory

Locations

341 S 3rd St
Columbus, OH 43215
Phone (614) 783-0405

Practitioners & affiliated clinicians

Practitioners 1

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": "1694390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756771200000",
    "number": "1083491419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 S 3RD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432155463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 EGRET CT",
            "city": "PICKERINGTON",
            "state": "OH",
            "postal_code": "431473403",
            "telephone_number": "740-415-6416",
            "fax_number": "614-321-4161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "341 S 3rd St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432155463",
            "country_code": "US",
            "telephone_number": "614-783-0405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CALVARY FAMILY PRACTICE AND MENTAL HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-11",
        "last_updated": "2025-09-02",
        "certification_date": "2024-07-16",
        "status": "A",
        "authorized_official_last_name": "EDO",
        "authorized_official_first_name": "MAGDALENE",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "CERTIFIED NURSE PRACTITIONER",
        "authorized_official_telephone_number": "740-415-6416",
        "authorized_official_credential": "FNP/PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Calvary Family and Mental Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pickerington, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; 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.