Organization Active NPI

Family Practice West Inc

  • Family Medicine Physician
  • Columbus, OH
National Provider Identifier
1104038595
Registry record updated Feb 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34008162 Issued in OH
Legal business name
FAMILY PRACTICE WEST INC
Practice address
5212 W Broad St
Columbus, OH 43228-1642
Phone
(614) 878-7285
Fax
(614) 878-1724
NPI assigned
May 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2008

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

Authorized official

Name
Jimilea Gutheil
Title
Office Manager
Phone
(614) 878-7285

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 34008162 OH Primary

Addresses

Primary practice location

5212 W Broad St
Columbus, OH 43228-1642

Mailing address

5212 W Broad St
Columbus, OH 43228-1642
Phone (614) 878-7285

Other identifiers 1

IdentifierTypeStateIssuer
2649076MedicaidOH

National Provider Directory

National Provider Directory

Locations

5212 W Broad St
Ste B
Columbus, OH 43228
Phone (614) 769-3342

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1178323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204070400000",
    "number": "1104038595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5212 W BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432281642",
            "telephone_number": "614-878-7285",
            "fax_number": "614-878-1724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5212 W BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432281642",
            "telephone_number": "614-878-7285",
            "fax_number": "614-878-1724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PRACTICE WEST INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-05",
        "last_updated": "2008-02-27",
        "status": "A",
        "authorized_official_last_name": "GUTHEIL",
        "authorized_official_first_name": "JIMILEA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "614-878-7285"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34008162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2649076",
            "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 Feb 27, 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.