Individual provider Active NPI

Bryan David Borland, DO

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Columbus, OH
National Provider Identifier
1457643637
Registry record updated Sep 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084A0401X
License
34.013478 Issued in OH
Practice address
815 W Broad St Ste 200
Columbus, OH 43222-1478
Phone
(614) 799-1906
NPI assigned
May 6, 2011
Last updated
Sep 23, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 34.013478 OH
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X 34.013478 OH Primary
Psychiatry Physician 2084P0800X 34.013478 OH

Addresses

Primary practice location

815 W Broad St Ste 200
Columbus, OH 43222-1478

Mailing address

815 W Broad St Ste 200
Columbus, OH 43222-1478
Phone (614) 799-1906

Other identifiers 1

IdentifierTypeStateIssuer
0298551MedicaidOH

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200925000133 OH Practitioner - Addiction Medicine 2769719053 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Addiction Medicine
Education
Ohio University, College of Osteopathic Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

16645 Square Dr
Marysville, OH 43040-3510
Phone (937) 250-1433

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
34.013478OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Springs Wellness Center LLC CurrentSince Jan 10, 2024 Accepting new patients
The Marysville Union Current Accepting new patients
Summit Springs Wellness Center LLC CurrentSince Jan 10, 2024 Accepting new patients
The Marysville Union Clubhouse CurrentSince Feb 22, 2022 Accepting new patients

Locations

6161 Busch Blvd
Ste 200201
Columbus, OH 43229
Phone (380) 203-2886

125 Executive Dr
Marion, OH 43302
Phone (740) 401-0880

16645 Square Dr
Marysville, OH 43040
Phone (513) 703-5078

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1304640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600819200000",
    "number": "1457643637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 W BROAD ST STE 200",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432221478",
            "telephone_number": "614-799-1906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 W BROAD ST STE 200",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432221478",
            "telephone_number": "614-799-1906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORLAND",
        "first_name": "BRYAN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-06",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34.013478",
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "OH",
            "license": "34.013478",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "34.013478",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0298551",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.