NPIMap

Organization Active NPI

Central Ohio Endoscopy Center, LLC

  • Endoscopy Clinic/Center
  • Pickerington, OH
National Provider Identifier
1386110575
Registry record updated Nov 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endoscopy Clinic/CenterTaxonomy code 261QE0800X
Legal business name
CENTRAL OHIO ENDOSCOPY CENTER, LLC
Practice address
1025 Refugee Rd FL 1
Pickerington, OH 43147-9861
Phone
(614) 754-5500
Fax
(614) 754-5501
NPI assigned
Oct 16, 2018
Last updated
Nov 8, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
CENTRAL OHIO ENDOSCOPY CENTER, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 8, 2018

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

Authorized official

Name
Bruce L Hennessy, MDNPI 1891788386
Title
Medical Director
Phone
(614) 754-5500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X
Endoscopy Clinic/Center 261QE0800X Primary

Addresses

Primary practice location

1025 Refugee Rd FL 1
Pickerington, OH 43147-9861

Mailing address

3400 Olentangy River Rd
Columbus, OH 43202-1523
Phone (614) 754-5500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250929000973 OH Part B Supplier - Ambulatory Surgical Center 2860553120 Practice locations: Pickerington, OH

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Central Ohio Endoscopy Center LLCCCN 36C0001319
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2156628Central Ohio Endoscopy Center, LLC1025 Refugee Road, Pickerington, OH 43147Certificate of waiverOct 21, 2026

National Provider Directory

National Provider Directory
Tax ID family
Central Ohio Endoscopy Center LLC6 organizations share this tax ID, including this one
Part of
Central Ohio Endoscopy Center LLC

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1025 Refugee Rd
Ste 100
Pickerington, OH 43147

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1539648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541635200000",
    "number": "1386110575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 OLENTANGY RIVER RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021523",
            "telephone_number": "614-754-5500",
            "fax_number": "614-457-9519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 REFUGEE RD FL 1",
            "city": "PICKERINGTON",
            "state": "OH",
            "postal_code": "431479861",
            "telephone_number": "614-754-5500",
            "fax_number": "614-754-5501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL OHIO ENDOSCOPY CENTER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTRAL OHIO ENDOSCOPY CENTER, LLC",
        "enumeration_date": "2018-10-16",
        "last_updated": "2018-11-08",
        "status": "A",
        "authorized_official_last_name": "HENNESSY",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "614-754-5500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QE0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Endoscopy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pickerington, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.