NPIMap

Organization Active NPI

Dedicated Columbus Ohio, LLC

Doing business as Dedicated Senior Medical Center West Broad St

  • Non-Pharmacy Dispensing Site
  • Columbus, OH
National Provider Identifier
1245791581
Registry record updated Apr 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
DEDICATED COLUMBUS OHIO, LLC
Doing business as
Dedicated Senior Medical Center West Broad St
Practice address
50 North Wilson Road
Columbus, OH 43204
Phone
(614) 702-7915
Fax
(305) 393-5989
NPI assigned
Mar 28, 2019
Last updated
Apr 3, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
DEDICATED COLUMBUS OHIO, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 3, 2020

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

Authorized official

Name
Mary Chen
Title
Owner
Phone
(305) 628-6117

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X Primary

Addresses

Primary practice location

50 North Wilson Road
Columbus, OH 43204

Mailing address

50 North Wilson Road
Columbus, OH 43204
Phone (614) 702-7915

Other names 1

  • Dedicated Senior Medical Center West Broad St Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2171955Dedicated Senior Medical Center50 North Wilson Road, Columbus, OH 43204Certificate of waiverSep 10, 2027

National Provider Directory

National Provider Directory
Tax ID family
Dedicated Columbus Ohio LLC4 organizations share this tax ID, including this one
Part of
Dedicated Columbus Ohio LLC

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1553731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585872000000",
    "number": "1245791581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 NORTH WILSON ROAD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "43204",
            "telephone_number": "614-702-7915",
            "fax_number": "305-393-5989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 NORTH WILSON ROAD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "43204",
            "telephone_number": "614-702-7915",
            "fax_number": "305-393-5989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEDICATED COLUMBUS OHIO, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DEDICATED COLUMBUS OHIO, LLC",
        "enumeration_date": "2019-03-28",
        "last_updated": "2020-04-03",
        "certification_date": "2020-04-03",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-628-6117"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dedicated Senior Medical Center West Broad St",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.