Organization Active NPI

Zanesville Family Practice Inc

  • Family Medicine Physician
  • Zanesville, OH
National Provider Identifier
1548339120
Registry record updated Apr 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ZANESVILLE FAMILY PRACTICE INC
Practice address
1215 Newark Road
Zanesville, OH 43701-2816
Phone
(740) 452-7359
Fax
(740) 452-7309
NPI assigned
Nov 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2020

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

Authorized official

Name
Mr. Kristofer Gibson SandlundNPI 1407844749
Title
Physician
Phone
(740) 452-7359

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1215 Newark Road
Zanesville, OH 43701-2816

Mailing address

1215 Newark Road
Zanesville, OH 43701-2816
Phone (740) 452-7359

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051215000126 OH Part B Supplier - Clinic/Group Practice 9830110089 Receives reassigned benefits from 2 practitioners
Practice locations: Zanesville, OH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D0332772Zanesville Family Practice Inc1215 Newark Road, Zanesville, OH 43701ComplianceJun 1, 2028

National Provider Directory

National Provider Directory

Locations

1215 Newark Rd
Zanesville, OH 43701
Phone (740) 452-7359

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588032000000",
    "number": "1548339120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 NEWARK ROAD",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437012816",
            "telephone_number": "740-452-7359",
            "fax_number": "740-452-7309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 NEWARK ROAD",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437012816",
            "telephone_number": "740-452-7359",
            "fax_number": "740-452-7309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZANESVILLE FAMILY PRACTICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2020-04-28",
        "certification_date": "2020-04-28",
        "status": "A",
        "authorized_official_last_name": "SANDLUND",
        "authorized_official_first_name": "KRISTOFER",
        "authorized_official_middle_name": "GIBSON",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "740-452-7359",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zanesville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.