Organization Active NPI

Central Ohio Colon and Rectal Ctr, Inc.

  • Surgery Physician
  • Columbus, OH
National Provider Identifier
1104976299
Registry record updated Nov 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
CENTRAL OHIO COLON AND RECTAL CTR, INC.
Practice address
5965 E Broad St
Suite 120
Columbus, OH 43213-1562
Phone
(614) 864-1000
Fax
(614) 864-1444
NPI assigned
Jan 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2011

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

Authorized official

Name
Miss Angela M. Whitt, ESQ.
Title
Administrator
Phone
(614) 864-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

5965 E Broad St
Suite 120
Columbus, OH 43213-1562

Mailing address

5965 East Broad Street
Suite 120
Columbus, OH 43213
Phone (614) 864-1000

Other identifiers 4

IdentifierTypeStateIssuer
0374929MedicaidOH
2313428MedicaidOH
2327897MedicaidOH
2313419MedicaidOH

National Provider Directory

National Provider Directory

Locations

4885 Olentangy River Rd
Ste 2-30
Columbus, OH 43214
Phone (614) 451-3388

285 E State St
Ste 515
Columbus, OH 43215
Phone (614) 224-2012

291 W Schrock Rd
Ste 2A
Westerville, OH 43081

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320192000000",
    "number": "1104976299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5965 EAST BROAD STREET",
            "address_2": "SUITE 120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "43213",
            "telephone_number": "614-864-1000",
            "fax_number": "614-864-1444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5965 E BROAD ST",
            "address_2": "SUITE 120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432131562",
            "telephone_number": "614-864-1000",
            "fax_number": "614-864-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL OHIO COLON AND RECTAL CTR, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2011-11-02",
        "status": "A",
        "authorized_official_last_name": "WHITT",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "614-864-1000",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "ESQ."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0374929",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2313428",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2327897",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2313419",
            "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 Nov 2, 2011; 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.