NPIMap

Organization Active NPI

Autumn Treatment Center LLC

  • Family Medicine Physician
  • Springfield, OH
National Provider Identifier
1104633221
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
AUTUMN TREATMENT CENTER LLC
Practice address
1176 E Home Rd
Springfield, OH 45503-2726
Phone
(614) 943-3839
NPI assigned
Dec 12, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Authorized official

Name
Madhukar Narahari
Title
Ceo
Phone
(614) 599-3800

Specialties & licenses 1

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

Addresses

Primary practice location

1176 E Home Rd
Springfield, OH 45503-2726

Mailing address

1176 E Home Rd
Springfield, OH 45503-2726
Phone (614) 943-3839

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211019002513 OH Part B Supplier - Clinic/Group Practice 6002204344 Receives reassigned benefits from 30 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Springfield, OH; Washington Court House, OH

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1612 Lancaster Ave
Reynoldsburg, OH 43068
Phone (614) 327-0535

Practitioners & affiliated clinicians

Practitioners 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1733961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733961600000",
    "number": "1104633221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1176 E HOME RD",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455032726",
            "telephone_number": "614-943-3839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1176 E HOME RD",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455032726",
            "telephone_number": "614-943-3839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUTUMN TREATMENT CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-12",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A",
        "authorized_official_last_name": "NARAHARI",
        "authorized_official_first_name": "MADHUKAR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "614-599-3800"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; 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.