Joseph R Mayo, MD – Cardiovascular Disease Physician

Key facts

NPI: 1285639641
Entity type: Individual (NPI type 1)
Primary specialty: Cardiovascular Disease Physician 207RC0000X
License: 35049513M (OH)
Practice address: 269 Portland Way S
Galion, OH 44833-2312
Phone: (419) 462-4600
Fax: (419) 462-4609
NPI assigned: Jun 14, 2005
Sex: Male
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Medicine

State licenses

License	State	Type	Specialty
35049513M	OH	MD	Cardiovascular Disease Physician
35049513	OH	MD	Interventional Cardiology Physician

Interoperability endpoints

Direct secure messaging: jmayo620811@direct.osumc.edu

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Interventional Cardiology Physician	207RI0011X	35049513	OH
Cardiovascular Disease Physician	207RC0000X	35049513M	OH	Yes

Addresses

Primary practice location

269 Portland Way S
Galion, OH 44833-2312

Mailing address

700 N Columbus St
Crestline, OH 44827-1455

Other identifiers

Identifier	Type	State	Issuer
0211510000	Medicaid	WV
0629029	Medicaid	OH
P01227144	Other	OH	RAILROAD MEDICARE - MMH

Electronic endpoints

Type	Endpoint	Use	Affiliation
Direct Messaging Address	jmayo620811@direct.osumc.edu

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 6, 2021.

{
    "created_epoch": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609891200000",
    "number": "1285639641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 N COLUMBUS ST",
            "city": "CRESTLINE",
            "state": "OH",
            "postal_code": "448271455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "269 PORTLAND WAY S",
            "city": "GALION",
            "state": "OH",
            "postal_code": "448332312",
            "telephone_number": "419-462-4600",
            "fax_number": "419-462-4609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYO",
        "first_name": "JOSEPH",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-14",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "OH",
            "license": "35049513",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "35049513M",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0211510000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0629029",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE - MMH",
            "identifier": "P01227144",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmayo620811@direct.osumc.edu",
            "affiliation": "N",
            "address_1": "269 Portland Way S",
            "city": "Galion",
            "state": "OH",
            "country_code": "US",
            "postal_code": "448332312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Galion, OH

All providers in Galion, OH · Cardiovascular Disease Physician in Ohio

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 6, 2021. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.