NPIMap

Organization Active NPI

Boundless Health, Inc.

  • Primary Care Clinic/Center
  • West Carrollton, OH
National Provider Identifier
1447739339
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
BOUNDLESS HEALTH, INC.
Practice address
700 Liberty LN
West Carrollton, OH 45449-2135
Phone
(937) 247-2400
NPI assigned
Aug 10, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Authorized official

Name
Michelle Barner
Title
Administrator
Phone
(614) 844-3800

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental - Behavioral Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0006X
Speech-Language PathologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 235Z00000X
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

700 Liberty LN
West Carrollton, OH 45449-2135

Mailing address

445 E Dublin Granville Rd
Worthington, OH 43085-3192
Phone (614) 844-3800

Other practice location 1

140 W Church St
Newark, OH 43055-5064
Phone (740) 334-4056

Other practice location 2

445 E Dublin Granville Rd
Worthington, OH 43085-3192
Phone (614) 436-7837 ext. 2280

Other identifiers 1

IdentifierTypeStateIssuer
0302515MedicaidOH

Other names 1

  • Boundless Behavioral Health, Inc. Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040922000682 OH Part B Supplier - Clinic/Group Practice 9931177425 Receives reassigned benefits from 19 practitioners
3 other NPIs on this enrollment
Practice locations: Medina, OH; Newark, OH; West Carrollton, OH; Worthington, OH

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Boundless Behavioral Health Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

140 W Church St
Newark, OH 43055
Phone (740) 334-4056

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1533859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694044800000",
    "number": "1447739339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 E DUBLIN GRANVILLE RD",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430853192",
            "telephone_number": "614-844-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 LIBERTY LN",
            "city": "WEST CARROLLTON",
            "state": "OH",
            "postal_code": "454492135",
            "telephone_number": "937-247-2400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "140 W Church St",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "OH",
            "postal_code": "430555064",
            "country_code": "US",
            "telephone_number": "740-334-4056",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "445 E Dublin Granville Rd",
            "address_purpose": "LOCATION",
            "city": "Worthington",
            "state": "OH",
            "postal_code": "430853192",
            "country_code": "US",
            "telephone_number": "614-436-7837 x2280",
            "fax_number": "614-436-8704",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BOUNDLESS HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-10",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A",
        "authorized_official_last_name": "BARNER",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "614-844-3800"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0302515",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boundless Behavioral Health, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in West Carrollton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.