Integrated Medicine of Ohio LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

INTEGRATED MEDICINE OF OHIO LLC

Practice address

2780 S Arlington Rd Ste 202
Coventry Township, OH 44312-4707

Phone

(330) 644-5488

Fax

(330) 644-5488

NPI assigned

Dec 2, 2019

Organization subpart

No

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

Authorized official

Name

Caroline Boardman

Title

Managing Member

Phone

(330) 644-5488

Specialties & licenses 1

Addresses

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Integrated Medicine of Ohio LLC

  • General Practice Physician
  • Independence, OH
  • NPI 1699306126
  NPPES parent name

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

{
    "created_epoch": "1575244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580169600000",
    "number": "1437796042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2780 S ARLINGTON RD STE 202",
            "city": "COVENTRY TOWNSHIP",
            "state": "OH",
            "postal_code": "443124707",
            "telephone_number": "330-644-5488",
            "fax_number": "330-644-5488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2780 S ARLINGTON RD STE 202",
            "city": "COVENTRY TOWNSHIP",
            "state": "OH",
            "postal_code": "443124707",
            "telephone_number": "330-644-5488",
            "fax_number": "330-644-5488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED MEDICINE OF OHIO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-02",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A",
        "authorized_official_last_name": "BOARDMAN",
        "authorized_official_first_name": "CAROLINE",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "330-644-5488"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Naudia Marie Haddox
• Healing Wounds Collective LLC
• Tamara Lynn Hershberger
• Brandi Hoffman-Westfall
• Christopher Gary Ilijevich, BSN, RN
• Kerry Maureen Jeric, LPCC, CDCA
• Roxana Jimenez
• Eslie Thomas Johnson, PRS, CDCA
• Nicole Marie Kavali, RN
• Laura Kidd, MA ED., LPCC/LICDC

• General Practice Physician in Coventry Township, OH
• Providers in Coventry Township, OH by specialty
• General Practice Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; 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.