Individual provider Active NPI

Nancy L. Graesser, D.O

  • Family Medicine Physician
  • Canal Winchester, OH
National Provider Identifier
1336252071
Registry record updated Mar 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34004238G Issued in OH
Practice address
7901 Diley Rd
Suite 200
Canal Winchester, OH 43110-9612
Phone
(614) 835-3838
Fax
(614) 834-4750
NPI assigned
Aug 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34004238G OH Primary

Addresses

Primary practice location

7901 Diley Rd
Suite 200
Canal Winchester, OH 43110-9612

Mailing address

7901 Diley Rd
Suite 200
Canal Winchester, OH 43110-9612
Phone (614) 835-3838

Other identifiers 1

IdentifierTypeStateIssuer
0638895MedicaidOH

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 Osteopathy

State licenses

LicenseStateTypeSpecialty
34004238GOHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eastside Family Practice, Inc. Family Medicine PastSince Oct 2, 2003 Accepting new patients

Organizations & group practices 1

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": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364169600000",
    "number": "1336252071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7901 DILEY RD",
            "address_2": "SUITE 200",
            "city": "CANAL WINCHESTER",
            "state": "OH",
            "postal_code": "431109612",
            "telephone_number": "614-835-3838",
            "fax_number": "614-834-4750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 DILEY RD",
            "address_2": "SUITE 200",
            "city": "CANAL WINCHESTER",
            "state": "OH",
            "postal_code": "431109612",
            "telephone_number": "614-835-3838",
            "fax_number": "614-834-4750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAESSER",
        "first_name": "NANCY",
        "middle_name": "L.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2013-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34004238G",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0638895",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canal Winchester, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2013; 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.