Old Tyme Family Medicine, LLC
Organization Active NPI Family Nurse Practitioner · London, OH
NPI 1114642907 · NPPES record last updated Feb 28, 2023
Key facts
- NPI
- 1114642907
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- Legal business name
- OLD TYME FAMILY MEDICINE, LLC
- Practice address
- 57 W High St
London, OH 43140-1050 - Phone
- (740) 490-7100
- Fax
- (740) 490-7055
- NPI assigned
- Oct 5, 2022
- Organization subpart
- No
Authorized official
- Name
- Morgan Steiskal, APRN, FNP
- Title
- Nurse Practitioner
- Phone
- (740) 490-7100
Practitioners 1
-
Morgan L. Steiskal, APRN-CNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230315003082 | OH | Part B Supplier - Clinic/Group Practice | 9335513233 |
Receives reassigned benefits from 1 practitioner Practice locations: London, OH |
National Provider Directory
Locations
57 W Main St
Shelby, OH 44875
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner |
363LF0000X | Yes |
Addresses
Primary practice location
57 W High St
London, OH 43140-1050
Mailing address
PO Box 138
Lewis Center, OH 43035
Phone (740) 490-7100
Other providers in London, OH
- Elliot L Neufeld
- Misty M. Nichols
- Angela Nickell
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- Tara Leigh Oiler
- Stephen Todd Olson
- Elizabeth Daniela Ortega
- Rebecca Pallay
- Park Avenue Family Practice Inc
- Barbara Parsons
All providers in London, OH · Family Nurse Practitioner in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 28, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.