Individual provider Active NPI

Justin Paul Gildow, F.N.P-BC

  • Family Nurse Practitioner
  • Bellefontaine, OH
National Provider Identifier
1134468168
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
14031 Issued in OH
Practice address
212 E Columbus Ave
Bellefontaine, OH 43311-2033
Phone
(937) 599-1411
Fax
(937) 599-4128
NPI assigned
Feb 12, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 14031 OH Primary

Addresses

Primary practice location

212 E Columbus Ave
Bellefontaine, OH 43311-2033

Mailing address

212 E Columbus Ave
Bellefontaine, OH 43311-2033
Phone (937) 599-1411

Other identifiers 2

IdentifierTypeStateIssuer
0101752MedicaidOH
14031OtherOHLICENSE NUMBER

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address justin.gildow@chwplc.eclinicaldirectplus.com

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130509000257 OH Practitioner - Nurse Practitioner 8123265238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health and Wellness Partners of Logan CountyGroup PAC ID 8022247469, 20 clinicians

Practice addresses (Care Compare)

4879 US RT 68
West Liberty, OH 43357-9525
Phone (937) 599-1411

Hospital & facility affiliations

  • Mary Rutan Hospital Hospital, Bellefontaine, OH, CCN 360197
  • Memorial Hospital Hospital, Marysville, OH, CCN 360092
  • Mercy Health St Ritas Medical Center Hospital, Lima, OH, CCN 360066

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
14031OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health & Wellness Partners of Logan County CurrentSince Jul 18, 2016 Accepting new patients
Community Health & Wellness Partners of Logan County CurrentSince Jul 18, 2016 Accepting new patients
Community Health & Wellness Partners of Logan County Past Accepting new patients
Community Health & Wellness Partners of Logan County Past Accepting new patients
Community Health & Wellness Partners of Logan County Past Accepting new patients
Community Health & Wellness Partners of Logan County Past Accepting new patients
Pathology Laboratories, Inc. PastSince Dec 10, 2023 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

212 E Columbus Ave
Ste 1
Bellefontaine, OH 43311
Phone (937) 599-1511

4560 County Road 26
Ste 2
Bellefontaine, OH 43311

8920 County Road 91
Ste 2
Lewistown, OH 43333

8200 State Route 366
Ste 1
Russells Pt, OH 43348
Phone (937) 633-0071

605 Miami St
Ste 100
Urbana, OH 43078

7208 US Highway 68 N
Ste 2
West Liberty, OH 43357

4879 US Highway 68 S
West Liberty, OH 43357
Phone (937) 599-5175

Interoperability endpoints

  • Direct secure messaging: justin.gildow@chwplc.eclinicaldirectplus.com

Organizations & group practices 8

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1360627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747353600000",
    "number": "1134468168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 E COLUMBUS AVE",
            "city": "BELLEFONTAINE",
            "state": "OH",
            "postal_code": "433112033",
            "telephone_number": "937-599-1411",
            "fax_number": "937-599-4128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 E COLUMBUS AVE",
            "city": "BELLEFONTAINE",
            "state": "OH",
            "postal_code": "433112033",
            "telephone_number": "937-599-1411",
            "fax_number": "937-599-4128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILDOW",
        "first_name": "JUSTIN",
        "middle_name": "PAUL",
        "credential": "F.N.P-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-12",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "14031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0101752",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "14031",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "justin.gildow@chwplc.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "4879 US Highway 68 S",
            "city": "West Liberty",
            "state": "OH",
            "country_code": "US",
            "postal_code": "433579525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bellefontaine, OH

Sources for this page

Verify at the official NPI Registry.