Individual provider Active NPI

James Glenn Fitkin, M.D.

  • Geriatric Medicine (Family Medicine) Physician
  • Columbus, OH
National Provider Identifier
1295846673
Registry record updated Jun 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
35072294 Issued in OH
Practice address
1733 Ardleigh Rd
Columbus, OH 43221-1401
Phone
(614) 949-4957
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 35072294 OH Primary

Addresses

Primary practice location

1733 Ardleigh Rd
Columbus, OH 43221-1401

Mailing address

1733 Ardleigh Rd
Columbus, OH 43221-1401
Phone (614) 949-4957

Other practice location 1

4794 Dierker Rd
Columbus, OH 43220-2968
Phone (614) 949-4957

Other identifiers 1

IdentifierTypeStateIssuer
2045834MedicaidOH

Medicare participation

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35072294OHMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hilliard Square Doctor'S Office, Inc. Past Accepting new patients
Mid-Ohio Emergency Services, LLC Past Accepting new patients

Organizations & group practices 2

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654300800000",
    "number": "1295846673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1733 ARDLEIGH RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432211401",
            "telephone_number": "614-949-4957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1733 ARDLEIGH RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432211401",
            "telephone_number": "614-949-4957"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4794 Dierker Rd",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432202968",
            "country_code": "US",
            "telephone_number": "614-949-4957",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FITKIN",
        "first_name": "JAMES",
        "middle_name": "GLENN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2022-06-04",
        "certification_date": "2022-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "OH",
            "license": "35072294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2045834",
            "state": "OH"
        }
    ],
    "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 Jun 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.