NPIMap

Organization Active NPI

Oh Independent Medical Group LLC

  • Family Medicine Physician
  • Columbus, OH
National Provider Identifier
1497482111
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
OH INDEPENDENT MEDICAL GROUP LLC
Practice address
3430 Ohio Health Pkwy
Columbus, OH 43202-1575
Phone
(614) 566-0152
NPI assigned
Aug 3, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Authorized official

Name
James O'Brien Jr., MD
Title
VP Operations, Population Health
Phone
(614) 544-4458

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

3430 Ohio Health Pkwy
Columbus, OH 43202-1575

Mailing address

3430 Ohiohealth Parkway
Columbus, OH 43202
Phone (614) 566-0152

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221027000414 OH Part B Supplier - Clinic/Group Practice 0648646034 Receives reassigned benefits from 174 practitioners
Practice locations: Lima, OH; Westerville, OH; Mansfield, OH; Marion, OH; Mogadore, OH; Pickerington, OH; Reynoldsburg, OH; Sunbury, OH…

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

2212 Mifflin Ave
Ste 140
Ashland, OH 44805
Phone (419) 289-4676

7750 Diley Rd
Ste A
Canal Winchester, OH 43110
Phone (614) 837-7337

4465 Fulton Dr NW
Ste 100
Canton, OH 44718
Phone (330) 497-2700

2929 Kenny Rd
Columbus, OH 43221
Phone (614) 442-1876

1194 Old Henderson Rd
Ste A
Columbus, OH 43220
Phone (614) 451-8797

7420 Gooding Blvd
#100
Delaware, OH 43015
Phone (740) 657-8000

7420 Gooding Blvd
Delaware, OH 43015

7450 Hospital Dr
Ste 4500
Dublin, OH 43016
Phone (614) 566-0166

1375 Cherry Way Dr
Ste 100
Gahanna, OH 43230
Phone (614) 566-0152

1069 Delaware Ave
Ste 205B
Marion, OH 43302
Phone (740) 387-4578

4900 Frank Ave NW
North Canton, OH 44720
Phone (330) 494-9797

1030 Refugee Rd
Ste 110
Pickerington, OH 43147

6482 E Main St
Reynoldsburg, OH 43068
Phone (614) 856-0327

7117 Tussing Rd
Reynoldsburg, OH 43068
Phone (614) 834-2600

123 State Route 3
Sunbury, OH 43074
Phone (740) 965-4301

487 W Main St
Ste A
West Jefferson, OH 43162
Phone (614) 879-7100

904 Eastwind Dr
Westerville, OH 43081
Phone (614) 890-1914

Practitioners & affiliated clinicians

Practitioners 219

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 219

NPI Registry JSON

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

{
    "created_epoch": "1659484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692057600000",
    "number": "1497482111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3430 OHIOHEALTH PARKWAY",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "43202",
            "telephone_number": "614-566-0152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3430 OHIO HEALTH PKWY",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021575",
            "telephone_number": "614-566-0152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OH INDEPENDENT MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-03",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A",
        "authorized_official_last_name": "O'BRIEN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "VP OPERATIONS, POPULATION HEALTH",
        "authorized_official_telephone_number": "614-544-4458",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.