Individual provider Active NPI

Nathan Michael Fagan, M.D.

  • Pediatric Radiology Physician
  • Columbus, OH
National Provider Identifier
1235495458
Registry record updated May 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Radiology PhysicianTaxonomy code 2085P0229X
License
35.133506 Issued in OH
Practice address
700 Childrens Dr
Columbus, OH 43205-2664
Phone
(614) 722-6200
NPI assigned
Apr 2, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 35133506 OH
Pediatric Radiology Physician 2085P0229X 35.133506 OH Primary

Addresses

Primary practice location

700 Childrens Dr
Columbus, OH 43205-2664

Mailing address

700 Childrens Dr
Columbus, OH 43205-2664
Phone (614) 722-2000

Other practice location 1

584 County Line Rd W
Westerville, OH 43082-7295
Phone (614) 722-6200

Other practice location 2

111 S Grant Ave
Columbus, OH 43215-4701
Phone (614) 722-6200

Other practice location 3

6435 E Broad St
Columbus, OH 43213-1507
Phone (614) 722-6200

Other practice location 4

5675 Venture Dr
Dublin, OH 43017-2159
Phone (614) 722-6200

Other practice location 5

75 S Terrace Ave
Newark, OH 43055-1355
Phone (614) 722-6200

Other practice location 6

433 N Cleveland Ave
Westerville, OH 43082-8095
Phone (614) 722-6200

Other practice location 7

3955 Brown Park Dr
Hilliard, OH 43026-3137
Phone (614) 722-6200

Other identifiers 2

IdentifierTypeStateIssuer
0404789MedicaidOH
H715592OtherOHCGS - MEDICARE

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
I20200527003159 OH Practitioner - Diagnostic Radiology 2668781444 Reassigns benefits to 5 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35133506OHMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Radiological Institute, Inc Pediatric Radiology CurrentSince Jun 1, 2021 Accepting new patients
Columbus Radiology Corp Diagnostic Radiology CurrentSince Jul 10, 2021 Accepting new patients
Nationwide Children'S Hospital CurrentSince Sep 25, 2024 Accepting new patients
Children'S Hospital Medical Center CurrentSince Jul 9, 2020 Accepting new patients
Nationwide Children'S Hospital CurrentSince Sep 25, 2024 Accepting new patients

Locations

3341 Solutions Ctr
Chicago, IL 60677

Dept 781629
Detroit, MI 48278

3333 Burnet Ave
#5031
Cincinnati, OH 45229
Phone (513) 636-4251

3188 Bellevue Ave
Cincinnati, OH 45219
Phone (513) 558-5281

2123 Auburn Ave
#A28
Cincinnati, OH 45219
Phone (513) 585-0523

3333 Burnet Ave
Cincinnati, OH 45229
Phone (513) 636-4200

111 S Grant Ave
Columbus, OH 43215
Phone (614) 461-3232

6435 E Broad St
Columbus, OH 43213
Phone (614) 355-8100

700 Childrens Dr
Columbus, OH 43205
Phone (614) 722-4411

1 Childrens Plz
Dayton, OH 45404
Phone (937) 641-3600

5675 Venture Dr
Dublin, OH 43017
Phone (614) 355-9580

3955 Brown Park Dr
Hilliard, OH 43026
Phone (614) 222-1999

75 S Terrace Ave
Newark, OH 43055
Phone (740) 522-3221

433 N Cleveland Ave
Westerville, OH 43082
Phone (614) 355-8300

584 County Line Rd W
Westerville, OH 43082
Phone (614) 355-6052

Organizations & group practices 6

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": "1333324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1235495458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 CHILDRENS DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052664",
            "telephone_number": "614-722-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 CHILDRENS DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052664",
            "telephone_number": "614-722-6200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "584 County Line Rd W",
            "address_purpose": "LOCATION",
            "city": "Westerville",
            "state": "OH",
            "postal_code": "430827295",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 S Grant Ave",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432154701",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6435 E Broad St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432131507",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5675 Venture Dr",
            "address_purpose": "LOCATION",
            "city": "Dublin",
            "state": "OH",
            "postal_code": "430172159",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "75 S Terrace Ave",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "OH",
            "postal_code": "430551355",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "433 N Cleveland Ave",
            "address_purpose": "LOCATION",
            "city": "Westerville",
            "state": "OH",
            "postal_code": "430828095",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3955 Brown Park Dr",
            "address_purpose": "LOCATION",
            "city": "Hilliard",
            "state": "OH",
            "postal_code": "430263137",
            "country_code": "US",
            "telephone_number": "614-722-6200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAGAN",
        "first_name": "NATHAN",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-02",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35133506",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "OH",
            "license": "35.133506",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0404789",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CGS - MEDICARE",
            "identifier": "H715592",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.