Shadi R Jurdi, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

35.131462 Issued in OH

Practice address

1030 Refugee Rd Ste 296
Pickerington, OH 43147-0047

Phone

(614) 788-4300

Fax

(614) 533-0191

NPI assigned

Jun 16, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in KY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Community Medical Associates, Inc.

  • Multi-Specialty Clinic/Center
  • Louisville, KY
  • NPI 1306983762
  Medicare reassignment NPD
• Community Medical Associates, Inc.

  • Orthopaedic Surgery of the Spine Physician
  • Louisville, KY
  • NPI 1437382074

  Internal Medicine

  NPD
• Community Medical Associates, Inc.

  • Internal Medicine Physician
  • Louisville, KY
  • NPI 1881192409
  NPD

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1427218064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 FRANTZ RD STE 360",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430164141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 REFUGEE RD STE 296",
            "city": "PICKERINGTON",
            "state": "OH",
            "postal_code": "431470047",
            "telephone_number": "614-788-4300",
            "fax_number": "614-533-0191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JURDI",
        "first_name": "SHADI",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-16",
        "last_updated": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "KY",
            "license": "47940",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.131462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02400009",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sjurdi184535@direct.ohiohealth.com",
            "affiliation": "Y",
            "affiliationName": "OhioHealth Physician Group",
            "address_1": "3773 Olentangy River Rd",
            "address_2": "1st Fl",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432143425",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Statoya Jones, QMHS
• Teara Jones
• Teonna Renee Jones
• Tyricka Ytina Jordan
• Joshua M. Leavitt D.M.D., M.S. LLC
• Just Kids Day Camp
• Hilary Kalra, PHD, BCBA-D
• Bethany Kalsic Wiley
• Hannah Kane
• Willmore Kanyongo

• Internal Medicine Physician in Pickerington, OH
• Providers in Pickerington, OH by specialty
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.