Healthserve Medical Group LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

HEALTHSERVE MEDICAL GROUP LLC

Doing business as

ExpressMed

Practice address

445 Rocky Fork Blvd
Gahanna, OH 43230-3336

Phone

(614) 442-2431

Fax

(614) 442-2426

NPI assigned

Nov 19, 2012

Last updated

Oct 2, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael C Bourland

Title

Secretary/Treasurer

Phone

(614) 442-2431

Specialties & licenses 2

Addresses

Other names 1

• ExpressMed Doing business as

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

{
    "created_epoch": "1353283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380672000000",
    "number": "1386988004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2939 KENNY RD STE 200",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432212406",
            "telephone_number": "614-442-2431",
            "fax_number": "614-442-2426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 ROCKY FORK BLVD",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432303336",
            "telephone_number": "614-442-2431",
            "fax_number": "614-442-2426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSERVE MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-19",
        "last_updated": "2013-10-02",
        "status": "A",
        "authorized_official_last_name": "BOURLAND",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "SECRETARY/TREASURER",
        "authorized_official_telephone_number": "614-442-2431"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ExpressMed",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Gahanna, OH
• Providers in Gahanna, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.