Individual provider Active NPI

Grant L Yoder, D.O.

  • Psychiatry Physician
  • Newark, OH
National Provider Identifier
1477714640
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
34011351 Issued in OH
Practice address
200 Messimer Dr
Newark, OH 43055
Phone
(220) 564-4873
Fax
(220) 564-4871
NPI assigned
Jun 20, 2008
Last updated
Mar 18, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 34011351 OH Primary

Addresses

Primary practice location

200 Messimer Dr
Newark, OH 43055

Mailing address

200 Messimer Dr
Newark, OH 43055
Phone (220) 564-4873

Other identifiers 1

IdentifierTypeStateIssuer
0104654MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gyoder14446@lickingmemorial.medicity.net

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
I20140811001116 OH Practitioner - Psychiatry 6709066905 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Oklahoma State University College of Osteopathic Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

120 McMillen Dr
Newark, OH 43055-1809
Phone (220) 564-4806

1320 W Main St
Newark, OH 43055-1822

200 Messimer Dr
Newark, OH 43055-3627
Phone (220) 564-4873

36 McMillen Dr
Newark, OH 43055-1809
Phone (220) 564-4270

88 McMillen Dr
Newark, OH 43055-1809
Phone (220) 564-4270

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.98 of 100Reported as group
Quality
75.66
Promoting interoperability
100
Improvement activities
40
Cost
75.38

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Licking Memorial Health Professionals Current Accepting new patients
Licking Memorial Professional Corporation CurrentSince Jul 2, 2014 Accepting new patients
Licking Memorial Professional Corporation CurrentSince Jul 2, 2014 Accepting new patients
Licking Memorial Hospital Current Accepting new patients
Licking Memorial Professional Corp. Past Accepting new patients

Locations

120 McMillen Dr
Newark, OH 43055
Phone (220) 564-4806

1320 W Main St
Newark, OH 43055
Phone (740) 348-4151

200 Messimer Dr
Newark, OH 43055
Phone (740) 348-4873

Interoperability endpoints

  • Direct secure messaging: gyoder14446@lickingmemorial.medicity.net

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1213920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1477714640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MESSIMER DR",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "43055",
            "telephone_number": "220-564-4873",
            "fax_number": "220-564-4871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MESSIMER DR",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "43055",
            "telephone_number": "220-564-4873",
            "fax_number": "220-564-4871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YODER",
        "first_name": "GRANT",
        "middle_name": "L",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-20",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "34011351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0104654",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gyoder14446@lickingmemorial.medicity.net",
            "affiliation": "N",
            "address_1": "200 Messimer Dr",
            "city": "Newark",
            "state": "OH",
            "country_code": "US",
            "postal_code": "43055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newark, OH

Sources for this page

Verify at the official NPI Registry.