Individual provider Active NPI

Jeannette Chary Dagam, DO

  • Psychiatry Physician
  • Columbus, OH
National Provider Identifier
1477760056
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
34.010316 Issued in OH
Practice address
3545 Olentangy River Rd Ste 220
Columbus, OH 43214-3907
Phone
(614) 566-4710
Fax
(614) 566-6636
NPI assigned
May 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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 34.010316 OH Primary

Addresses

Primary practice location

3545 Olentangy River Rd Ste 220
Columbus, OH 43214-3907

Mailing address

5450 Frantz Rd Ste 360
Dublin, OH 43016-4141
Phone (614) 544-6155

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jdagam421151@direct.ohiohealth.com OhioHealth Physician Group

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
I20111108000265 OH Practitioner - Psychiatry 8527248772 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohiohealth CorporationGroup PAC ID 6305758426, 2,295 clinicians

Practice addresses (Care Compare)

3545 Olentangy River Rd
Suite 200
Columbus, OH 43214-3907
Phone (614) 533-5500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.04 of 100Reported as group
Quality
58.67
Promoting interoperability
98
Improvement activities
40
Cost
76.46

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34.010316OHMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation CurrentSince Aug 1, 2020 Accepting new patients
State of Ohio Office of Budget and Management State Accounting Current Accepting new patients
State of Ohio Office of Budget and Management State Accounting CurrentSince Aug 24, 2015 Accepting new patients
State of Ohio Office of Budget and Management State Accounting CurrentSince Aug 24, 2015 Accepting new patients
Ohiohealth Corporation CurrentSince Aug 1, 2020 Accepting new patients
Ohiohealth Corporation Past Accepting new patients

Locations

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

3545 Olentangy River Rd
Ste 200
Columbus, OH 43214
Phone (614) 259-6938

Dept L3652
Columbus, OH 43260

30 E Broad St
Fl 11
Columbus, OH 43215
Phone (614) 466-9930

3545 Olentangy River Rd
Ste 220
Columbus, OH 43214
Phone (614) 566-4710

2200 W Broad St
Columbus, OH 43223

5450 Frantz Rd
Ste 360
Dublin, OH 43016
Phone (614) 533-6497

Organizations & group practices 6

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 2

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": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1477760056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 FRANTZ RD STE 360",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430164141",
            "telephone_number": "614-544-6155",
            "fax_number": "614-544-6370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3545 OLENTANGY RIVER RD STE 220",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432143907",
            "telephone_number": "614-566-4710",
            "fax_number": "614-566-6636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAGAM",
        "first_name": "JEANNETTE",
        "middle_name": "CHARY",
        "name_prefix": "Miss",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-16",
        "last_updated": "2022-01-25",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "34.010316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jdagam421151@direct.ohiohealth.com",
            "affiliation": "Y",
            "affiliationName": "OhioHealth Physician Group",
            "address_1": "3545 Olentangy River Rd",
            "address_2": "Ste 220",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432143907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.