Individual provider Active NPI

Jade Flowers, IMFT

  • Marriage & Family Therapist
  • Columbus, OH
National Provider Identifier
1134486293
Registry record updated Nov 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
M1300023 Issued in OH
Practice address
3242 Henderson Rd Ste a
Columbus, OH 43220-2307
Phone
(614) 284-2808
Fax
(614) 999-1306
NPI assigned
Apr 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X M1300023 OH Primary

Addresses

Primary practice location

3242 Henderson Rd Ste a
Columbus, OH 43220-2307

Mailing address

349 E Cooke Rd
Columbus, OH 43214-2801
Phone (614) 284-2808

Other identifiers 1

IdentifierTypeStateIssuer
0291249MedicaidOH

Other names 1

  • Jade Rothacker Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Mar 1, 2024 through Mar 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
M1300023OHMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1334275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730419200000",
    "number": "1134486293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "349 E COOKE RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432142801",
            "telephone_number": "614-284-2808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3242 HENDERSON RD STE A",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432202307",
            "telephone_number": "614-284-2808",
            "fax_number": "614-999-1306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLOWERS",
        "first_name": "JADE",
        "credential": "IMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-13",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OH",
            "license": "M1300023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0291249",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JADE",
            "last_name": "ROTHACKER",
            "credential": "IMFT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.