Individual provider Active NPI

Jennifer Mitzman

  • Emergency Medicine Physician
  • Columbus, OH
National Provider Identifier
1124260807
Registry record updated Feb 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35123808 Issued in OH
Practice address
376 W 10TH Ave
780 Prior Hall
Columbus, OH 43210-1280
Phone
(614) 293-8305
NPI assigned
Mar 27, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X 35123808 OH
Emergency Medicine Physician 207P00000X 35123808 OH Primary

Addresses

Primary practice location

376 W 10TH Ave
780 Prior Hall
Columbus, OH 43210-1280

Mailing address

376 W 10TH Ave
780 Prior Hall
Columbus, OH 43210-1280

Other practice location 1

7901 Diley Rd Ste 150
Canal Winchester, OH 43110-9613
Phone (614) 355-9050

Other practice location 2

444 Butterfly Gardens Dr
Columbus, OH 43215-3427
Phone (614) 722-2000

Other practice location 3

7853 Pacer Dr
Delaware, OH 43015-7571
Phone (614) 355-7900

Other practice location 4

100 Colemans Xing
Marysville, OH 43040-7080
Phone (937) 578-7600

Other practice location 5

7450 Hospital Dr Ste 100
Dublin, OH 43016-8364
Phone (614) 355-7000

Other practice location 6

433 N Cleveland Ave
Westerville, OH 43082-8095
Phone (614) 355-8300

Other practice location 7

4363 All Seasons Dr Ste 100
Hilliard, OH 43026-2050
Phone (614) 355-5900

Other identifiers 1

IdentifierTypeStateIssuer
0106379MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140926001456 OH Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 0648426114 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35123808OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nationwide Children'S Hospital CurrentSince Sep 20, 2024 Accepting new patients
Pediatric Academic Association, Inc. CurrentSince Aug 12, 2014 Accepting new patients
Osu Observation Medicine, LLC Emergency Medicine CurrentSince Jul 1, 2019 Accepting new patients
Nationwide Children'S Hospital CurrentSince Sep 20, 2024 Accepting new patients
Osu Emergency Medicine LLC CurrentSince Sep 27, 2014 Accepting new patients
Nationwide Children'S Hospital Past Accepting new patients

Locations

Dept 781629
Detroit, MI 48278

7901 Diley Rd
Ste 150
Canal Winchester, OH 43110
Phone (614) 355-9050

700 Childrens Dr
Columbus, OH 43205
Phone (614) 722-4411

444 Butterfly Gardens Dr
Columbus, OH 43215
Phone (614) 938-0167

555 S 18th St
Columbus, OH 43205
Phone (614) 722-4554

410 W 10th Ave
Columbus, OH 43210
Phone (614) 293-5905

Dept L289
Columbus, OH 43260

1 Childrens Plz
Dayton, OH 45404
Phone (937) 641-3600

7853 Pacer Dr
Delaware, OH 43015
Phone (614) 355-7900

7450 Hospital Dr
Ste 100
Dublin, OH 43016
Phone (614) 355-7000

4363 All Seasons Dr
Ste 100
Hilliard, OH 43026
Phone (614) 355-5900

100 Colemans Crossing Blvd
Marysville, OH 43040
Phone (937) 578-7600

433 N Cleveland Ave
Westerville, OH 43082
Phone (614) 355-8300

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1238112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1124260807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "376 W 10TH AVE",
            "address_2": "780 PRIOR HALL",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "376 W 10TH AVE",
            "address_2": "780 PRIOR HALL",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101280",
            "telephone_number": "614-293-8305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7901 Diley Rd Ste 150",
            "address_purpose": "LOCATION",
            "city": "Canal Winchester",
            "state": "OH",
            "postal_code": "431109613",
            "country_code": "US",
            "telephone_number": "614-355-9050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "444 Butterfly Gardens Dr",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432153427",
            "country_code": "US",
            "telephone_number": "614-722-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7853 Pacer Dr",
            "address_purpose": "LOCATION",
            "city": "Delaware",
            "state": "OH",
            "postal_code": "430157571",
            "country_code": "US",
            "telephone_number": "614-355-7900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Colemans Xing",
            "address_purpose": "LOCATION",
            "city": "Marysville",
            "state": "OH",
            "postal_code": "430407080",
            "country_code": "US",
            "telephone_number": "937-578-7600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7450 Hospital Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Dublin",
            "state": "OH",
            "postal_code": "430168364",
            "country_code": "US",
            "telephone_number": "614-355-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "433 N Cleveland Ave",
            "address_purpose": "LOCATION",
            "city": "Westerville",
            "state": "OH",
            "postal_code": "430828095",
            "country_code": "US",
            "telephone_number": "614-355-8300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4363 All Seasons Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Hilliard",
            "state": "OH",
            "postal_code": "430262050",
            "country_code": "US",
            "telephone_number": "614-355-5900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITZMAN",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-27",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "OH",
            "license": "35123808",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35123808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0106379",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.