Active NPI
Padet Wattanasarn, M.D.
- Neurology Physician
- Columbus, OH
National Provider Identifier
1174059174
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 35.034314
- Practice address
- 1070 Circle on the GRN
Columbus, OH 43235-1211 - Phone
- (614) 718-9041
- NPI assigned
- May 11, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 35.034314 | OH | Primary |
Addresses
Primary practice location
1070 Circle on the GRN
Columbus, OH 43235-1211
Mailing address
1070 Circle on the GRN
Columbus, OH 43235-1211
Phone (614) 718-9041
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35.034314 | OH | MD | Neurology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1494460800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1494460800000",
"number": "1174059174",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1070 CIRCLE ON THE GRN",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432351211",
"telephone_number": "614-718-9041"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1070 CIRCLE ON THE GRN",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432351211",
"telephone_number": "614-718-9041"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATTANASARN",
"first_name": "PADET",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-05-11",
"last_updated": "2017-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "OH",
"license": "35.034314",
"primary": true
}
],
"identifiers": [],
"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 May 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.