Individual provider Active NPI

Wayde D.H. Dazelle, MD, MS

  • Internal Medicine Physician
  • Columbus, OH
National Provider Identifier
1376245324
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35.156193 Issued in OH
Practice address
1405 S High St
Columbus, OH 43207-1043
Phone
(614) 355-9000
Fax
(614) 355-9010
NPI assigned
Mar 21, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35.156193 OH Primary
Pediatrics Physician 208000000X 35.156193 OH

Addresses

Primary practice location

1405 S High St
Columbus, OH 43207-1043

Mailing address

1405 S High St
Columbus, OH 43207-1043
Phone (614) 355-9000

Other names 1

  • Wade D.H. Dazelle Former name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230630001285 OH Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 1052770542

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.156193OHMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1679356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1376245324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 S HIGH ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432071043",
            "telephone_number": "614-355-9000",
            "fax_number": "614-355-9010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 S HIGH ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432071043",
            "telephone_number": "614-355-9000",
            "fax_number": "614-355-9010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAZELLE",
        "first_name": "WAYDE",
        "middle_name": "D.H.",
        "credential": "MD, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-21",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.156193",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.156193",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WADE",
            "last_name": "DAZELLE",
            "middle_name": "D.H.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.