NPIMap

Organization Active NPI

Columbus Physician Resources Inc

Doing business as Fourth and Diamond Medical Clinic

  • Specialist
  • Mansfield, OH
National Provider Identifier
1447378567
Registry record updated Feb 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
COLUMBUS PHYSICIAN RESOURCES INC
Doing business as
Fourth and Diamond Medical Clinic
Practice address
380 Cline Ave Ste 1
Mansfield, OH 44907-1056
Phone
(419) 571-5290
Fax
(419) 522-0998
NPI assigned
Mar 27, 2007
Last updated
Feb 10, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2020

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

Authorized official

Name
Dr. Paul Ritenour, D.O.NPI 1598726028
Title
DO
Phone
(419) 571-5290

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

380 Cline Ave Ste 1
Mansfield, OH 44907-1056

Mailing address

380 Cline Ave Ste 1
Mansfield, OH 44907-1056
Phone (419) 571-5290

Other identifiers 2

IdentifierTypeStateIssuer
2075276MedicaidOH
000000122735OtherOHANTHEM BCBS OF OH

Other names 1

  • Fourth and Diamond Medical Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

380 Cline Ave
Mansfield, OH 44907

2152 Walker Lake Rd
#357
Ontario, OH 44903

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581292800000",
    "number": "1447378567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 CLINE AVE STE 1",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449071056",
            "telephone_number": "419-571-5290",
            "fax_number": "419-522-0998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 CLINE AVE STE 1",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449071056",
            "telephone_number": "419-571-5290",
            "fax_number": "419-522-0998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBUS PHYSICIAN RESOURCES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A",
        "authorized_official_last_name": "RITENOUR",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "DO",
        "authorized_official_telephone_number": "419-571-5290",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2075276",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS OF OH",
            "identifier": "000000122735",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fourth and Diamond Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fourth and Diamond Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mansfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.