Modern Allergy, LLC

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

Legal business name

MODERN ALLERGY, LLC

Practice address

3535 Fishinger Blvd Ste 280
Hilliard, OH 43026-7568

Phone

(614) 758-7600

Fax

(614) 758-7609

NPI assigned

Apr 13, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Gregory Hayward Bennett, DONPI 1376819524

Title

President & Physician

Phone

(614) 758-7600

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/26563/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gregory Hayward Bennett, DO

  • Allergy & Immunology Physician
  • Hilliard, OH
  • NPI 1376819524
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1649808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685664000000",
    "number": "1356083802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 FISHINGER BLVD",
            "address_2": "STE. 280",
            "city": "HILLIARD",
            "state": "OH",
            "postal_code": "430267568",
            "telephone_number": "614-758-7600",
            "fax_number": "614-758-7609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 FISHINGER BLVD STE 280",
            "city": "HILLIARD",
            "state": "OH",
            "postal_code": "430267568",
            "telephone_number": "614-758-7600",
            "fax_number": "614-758-7609"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "625 Africa Rd Ste 340",
            "address_purpose": "LOCATION",
            "city": "Westerville",
            "state": "OH",
            "postal_code": "430829830",
            "country_code": "US",
            "telephone_number": "614-758-7600",
            "fax_number": "614-758-7609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MODERN ALLERGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-13",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "HAYWARD",
        "authorized_official_title_or_position": "PRESIDENT & PHYSICIAN",
        "authorized_official_telephone_number": "614-758-7600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Allergy & Immunology Physician in Hilliard, OH
• Providers in Hilliard, OH by specialty
• Allergy & Immunology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.