Individual provider Active NPI

Kelly Irwin, DO

  • Pediatrics Physician
  • Columbus, OH
National Provider Identifier
1497250971
Registry record updated May 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
58.030406 Issued in OH
Practice address
700 Childrens Dr
Columbus, OH 43205
Phone
(614) 722-4411
NPI assigned
Mar 27, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 58.030406 OH Primary

Addresses

Primary practice location

700 Childrens Dr
Columbus, OH 43205

Mailing address

700 Childrens Dr
Columbus, OH 43205-2664
Phone (614) 722-4411

Other practice location 1

2054 S Green Rd
South Euclid, OH 44121-4243
Phone (216) 291-9287

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
I20210701003881 OH Practitioner - Pediatric Medicine 2163779943 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospitals Medical Group Inc Pediatrics CurrentSince Jul 26, 2021 Accepting new patients
Dr. Shelly David Senders, MD, Inc Pediatrics PastSince Jul 15, 2021 Accepting new patients

Locations

11100 Euclid Ave
Cleveland Heights, OH 44106

700 Childrens Dr
#274
Columbus, OH 43205

700 Childrens Dr
Columbus, OH 43205
Phone (614) 722-4411

Interoperability endpoints

  • Direct secure messaging: kirwin37997@ehrdirect.uhhospitals.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1522108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620518400000",
    "number": "1497250971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 CHILDRENS DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052664",
            "telephone_number": "614-722-4411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 CHILDRENS DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "43205",
            "telephone_number": "614-722-4411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2054 S Green Rd",
            "address_purpose": "LOCATION",
            "city": "South Euclid",
            "state": "OH",
            "postal_code": "441214243",
            "country_code": "US",
            "telephone_number": "216-291-9287",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IRWIN",
        "first_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-27",
        "last_updated": "2021-05-09",
        "certification_date": "2021-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "58.030406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.