Individual provider Active NPI

Crystal Kalogris, DO

  • Family Medicine Physician
  • Marion, OH
National Provider Identifier
1477112811
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34.015799 Issued in OH
Practice address
130 University Dr
Marion, OH 43302-1117
Phone
(740) 692-4450
Fax
(740) 692-4451
NPI assigned
Jun 10, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 11020373A IN
Family Medicine Physician 207Q00000X 34.015799 OH Primary

Addresses

Primary practice location

130 University Dr
Marion, OH 43302-1117

Mailing address

PO Box 7527
Dublin, OH 43017-0727
Phone (419) 520-2495

Other identifiers 1

IdentifierTypeStateIssuer
0492146MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ckalogris777366@direct.ohiohealth.com Marion Area Physicians LLC

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
I20220701002139 OH Practitioner - Family Practice 3173858396 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marion Area Physicians LLCGroup PAC ID 1850549437, 179 clinicians

Practice addresses (Care Compare)

130 University Dr
Suite 1100
Marion, OH 43302-1104
Phone (740) 692-4450

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Marion Area Physicians LLC Family Medicine CurrentSince Jul 1, 2022 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

Dept L3652
Columbus, OH 43260

130 University Dr
Ste 1100
Marion, OH 43302
Phone (740) 692-4450

1040 Delaware Ave
Marion, OH 43302
Phone (330) 256-9874

130 University Dr
Marion, OH 43302
Phone (740) 386-2381

Organizations & group practices 2

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1560124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1477112811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7527",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430170727",
            "telephone_number": "419-520-2495",
            "fax_number": "614-544-6370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 UNIVERSITY DR",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433021117",
            "telephone_number": "740-692-4450",
            "fax_number": "740-692-4451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALOGRIS",
        "first_name": "CRYSTAL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-10",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "11020373A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34.015799",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0492146",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ckalogris777366@direct.ohiohealth.com",
            "affiliation": "Y",
            "affiliationName": "Marion Area Physicians LLC",
            "address_1": "130 University Dr",
            "city": "Marion",
            "state": "OH",
            "country_code": "US",
            "postal_code": "433021117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marion, OH

Sources for this page

Verify at the official NPI Registry.