NPIMap

Organization Active NPI

Ridgeline Recovery LLC

  • Family Medicine Physician
  • Columbus, OH
National Provider Identifier
1104710193
Registry record updated Jun 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
RIDGELINE RECOVERY LLC
Practice address
491 Georgesville Rd
Columbus, OH 43228-2420
Phone
(614) 618-5000
Fax
(614) 618-9586
NPI assigned
Jun 5, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2025

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

Authorized official

Name
Brian Dean
Title
Admin
Phone
(614) 762-5206

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

491 Georgesville Rd
Columbus, OH 43228-2420

Mailing address

491 Georgesville Rd
Columbus, OH 43228-2420
Phone (614) 618-5000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211217002197 OH Part B Supplier - Clinic/Group Practice 1658762034 Receives reassigned benefits from 7 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Columbus, 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
Tax ID family
Ridgeline Recovery LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2283 Sunbury Rd
Columbus, OH 43219
Phone (614) 618-5000

Practitioners & affiliated clinicians

Practitioners 7

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": "1749081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749081600000",
    "number": "1104710193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "491 GEORGESVILLE RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432282420",
            "telephone_number": "614-618-5000",
            "fax_number": "614-618-9586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "491 GEORGESVILLE RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432282420",
            "telephone_number": "614-618-5000",
            "fax_number": "614-618-9586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDGELINE RECOVERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-05",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A",
        "authorized_official_last_name": "DEAN",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "614-762-5206"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "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 Jun 5, 2025; 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.