Individual provider Active NPI

Jennifer D. Mejilla Burton, D.O.

  • Vascular Neurology Physician
  • Columbus, OH
National Provider Identifier
1225237969
Registry record updated Dec 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Neurology PhysicianTaxonomy code 2084V0102X
License
34.010620 Issued in OH
Practice address
420 N James Rd
Columbus, OH 43219
Phone
(614) 257-5200
NPI assigned
Jul 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Neurology Physician 2084V0102X 34.010620 OH Primary

Addresses

Primary practice location

420 N James Rd
Columbus, OH 43219

Mailing address

420 N James Rd
Columbus, OH 43219-1834
Phone (614) 257-5200

Other practice location 1

4100 W 3rd St
Dayton, OH 45428-9000
Phone (937) 268-6511 ext. 3906

Other identifiers 1

IdentifierTypeStateIssuer
0071564MedicaidOH

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211011002785 OH Order and Referring Only - NeurologyPractitioner - Neurology 0749438372

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
34.010620OHMDVascular Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lima Memorial Joint Operating Company Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jennier.mejilla@mmhs.medicity.net

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544745600000",
    "number": "1225237969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 N JAMES RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432191834",
            "telephone_number": "614-257-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 N JAMES RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "43219",
            "telephone_number": "614-257-5200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4100 W 3rd St",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454289000",
            "country_code": "US",
            "telephone_number": "937-268-6511 x3906",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEJILLA BURTON",
        "first_name": "JENNIFER",
        "middle_name": "D.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-12",
        "last_updated": "2018-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "OH",
            "license": "34.010620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0071564",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.