Active NPI
Jack William Healy, MD
- Student in an Organized Health Care Education/Training Program
- Columbus, OH
National Provider Identifier
1285485649
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 376 W. 10TH Ave
774 Prior Hall
Columbus, OH 43210 - Phone
- (614) 293-8306
- NPI assigned
- Apr 1, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
376 W. 10TH Ave
774 Prior Hall
Columbus, OH 43210
Mailing address
376 W. 10TH Ave
774 Prior Hall
Columbus, OH 43210
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240524000800 | OH | Order and Referring Only - Emergency Medicine | 2668814443 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- jack.healy.1@19221.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1711929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711929600000",
"number": "1285485649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "376 W. 10TH AVE",
"address_2": "774 PRIOR HALL",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "43210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "376 W. 10TH AVE",
"address_2": "774 PRIOR HALL",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "43210",
"telephone_number": "614-293-8306"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEALY",
"first_name": "JACK",
"middle_name": "WILLIAM",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-04-01",
"last_updated": "2024-04-01",
"certification_date": "2024-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"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 Apr 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.