Northeast Family Practice

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

052152 Issued in OH

Legal business name

NORTHEAST FAMILY PRACTICE

Practice address

6200 Cleveland Ave
Suite 101
Columbus, OH 43231-8608

Phone

(614) 898-0150

Fax

(614) 898-0694

NPI assigned

Dec 7, 2007

Last updated

Apr 20, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Keith Allen Blakely, M.D.

Title

Physician

Phone

(614) 898-0150

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Melissa A. Dine, D.O.

  • General Practice Physician
  • Columbus, OH
  • NPI 1700084787
  NPD (past)

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

{
    "created_epoch": "1196985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1205019643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 CLEVELAND AVE",
            "address_2": "SUITE 101",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432318608",
            "telephone_number": "614-898-0150",
            "fax_number": "614-898-0694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 CLEVELAND AVE",
            "address_2": "SUITE 101",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432318608",
            "telephone_number": "614-898-0150",
            "fax_number": "614-898-0694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-07",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "BLAKELY",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "614-898-0150",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "052152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Columbus, OH
• Providers in Columbus, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.