NPIMap

Organization Active NPI

Osu Psychiatry, LLC

  • Clinical Child & Adolescent Psychologist
  • Columbus, OH
National Provider Identifier
1194773317
Registry record updated May 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
Legal business name
OSU PSYCHIATRY, LLC
Practice address
1670 Upham Dr
Suite 140
Columbus, OH 43210-1250
Phone
(614) 293-9600
Fax
(614) 293-4200
NPI assigned
May 4, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Amanda Lucas
Title
Executive Director Osu & Harding
Phone
(614) 293-8283

Practitioners 185

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 185

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, MA, CA3 enrollments

Medicare enrollment records 3

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20040331000566 OH Part B Supplier - Clinic/Group Practice 0749272714 Receives reassigned benefits from 175 practitioners
Practice locations: Columbus, OH; Westerville, OH; Upper Arlington, OH; New Albany, OH; Granville, OH; Dublin, OH
O20240221000449 MA Part B Supplier - Clinic/Group Practice 0749272714 Receives reassigned benefits from 1 practitioner
Practice locations: Tewksbury, MA
O20240808003679 CA Part B Supplier - Clinic/Group Practice 0749272714 Receives reassigned benefits from 1 practitioner
Practice locations: Granite Bay, CA

National Provider Directory

National Provider Directory

Locations

1670 Upham Dr
Ste 140
Columbus, OH 43210

1670 Upham Dr
Fl 3
Columbus, OH 43210

3650 Olentangy River Rd
Fl 3
Columbus, OH 43214

7171 Sawmill Pkwy
Powell, OH 43065

Specialties & licenses 3

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Clinical Child & Adolescent PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC2200X Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

NPPES NPI Registry

Primary practice location

1670 Upham Dr
Suite 140
Columbus, OH 43210-1250

Mailing address

1670 Upham Dr
Suite 140
Columbus, OH 43210-1250
Phone (614) 293-9600

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
2454035MedicaidOH

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 31, 2012.

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338422400000",
    "number": "1194773317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1670 UPHAM DR",
            "address_2": "SUITE 140",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101250",
            "telephone_number": "614-293-9600",
            "fax_number": "614-293-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1670 UPHAM DR",
            "address_2": "SUITE 140",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101250",
            "telephone_number": "614-293-9600",
            "fax_number": "614-293-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OSU PSYCHIATRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-04",
        "last_updated": "2012-05-31",
        "status": "A",
        "authorized_official_last_name": "LUCAS",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR OSU & HARDING",
        "authorized_official_telephone_number": "614-293-8283"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2454035",
            "state": "OH"
        }
    ],
    "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 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.