Individual provider Active NPI

Eric Richard Menke

  • Endodontics
  • Worthington, OH
National Provider Identifier
1427065721
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
30020979 Issued in OH
Practice address
6827 North High Street Suite 115
Worthington, OH 43085
Phone
(614) 885-1191
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 30020979 OH Primary

Addresses

Primary practice location

6827 North High Street Suite 115
Worthington, OH 43085

Mailing address

6827 North High Street Suite 115
Worthington, OH 43085
Phone (614) 885-1191

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130620000706 OH Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2769621838

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30020979OHMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Ohio Endodontics Endodontics Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427065721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6827 NORTH HIGH STREET SUITE 115",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "43085",
            "telephone_number": "614-885-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6827 NORTH HIGH STREET SUITE 115",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "43085",
            "telephone_number": "614-885-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENKE",
        "first_name": "ERIC",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "OH",
            "license": "30020979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worthington, OH

Sources for this page

Verify at the official NPI Registry.