NPIMap

Individual provider Active NPI

Angela Eubanks

  • Family Medicine Physician
  • Granville, OH
National Provider Identifier
1386681104
Registry record updated Mar 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35067240 - E Issued in OH
Practice address
1945 Newark Granville Rd
Granville, OH 43023-9169
Phone
(740) 587-0870
NPI assigned
Jun 1, 2006
Last updated
Mar 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2022

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 35067240 - E OH Primary

Addresses

Primary practice location

1945 Newark Granville Rd
Granville, OH 43023-9169

Mailing address

PO Box 951603
Cleveland, OH 44193-0018

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aeubanks1157892@direct.trinity-health.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051012001247 OH Practitioner - Family Practice 6901821511 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio State University College of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mount Carmel Healthproviders IncGroup PAC ID 9537073804, 140 clinicians

Practice addresses (Care Compare)

1945 Newark Granville Rd
Granville, OH 43023-9169
Phone (614) 627-1870

55 N High St
New Albany, OH 43054-7099
Phone (614) 627-1878

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35067240 - EOHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Carmel Healthproviders Inc Family Medicine CurrentSince Oct 22, 1996 Accepting new patients
Mount Carmel Health Providers Inc Family Medicine CurrentSince Oct 22, 1996 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

6150 E Broad St
Columbus, OH 43213
Phone (614) 546-4400

1945 Newark Granville Rd
Granville, OH 43023
Phone (614) 627-1870

55 N High St
New Albany, OH 43054
Phone (614) 627-1878

Interoperability endpoints

  • Direct secure messaging: aeubanks1157892@direct.trinity-health.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647388800000",
    "number": "1386681104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 951603",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1945 NEWARK GRANVILLE RD",
            "city": "GRANVILLE",
            "state": "OH",
            "postal_code": "430239169",
            "telephone_number": "740-587-0870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EUBANKS",
        "first_name": "ANGELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-01",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35067240 - E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aeubanks1157892@direct.trinity-health.org",
            "affiliation": "N",
            "endpointDescription": "Mount Carmel Health Columbus Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1945 Newark Granville Rd",
            "city": "Granville",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430239169",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Granville, OH

Sources for this page

Verify at the official NPI Registry.