Active NPI
Mary Lynn Kiacz, M.D.
- Contractor
- Columbus, OH
National Provider Identifier
1568436970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 35-045382
- Practice address
- 1875 Millikin Rd
Columbus, OH 43210-2200 - Phone
- (614) 292-0110
- Fax
- (614) 247-6074
- NPI assigned
- Feb 14, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 35-045382 | OH | Primary |
Addresses
Primary practice location
1875 Millikin Rd
Columbus, OH 43210-2200
Mailing address
1875 Millikin Rd
Columbus, OH 43210-2200
Phone (614) 292-0110
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0760556 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35-045382 | OH | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1568436970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1875 MILLIKIN RD",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432102200",
"telephone_number": "614-292-0110",
"fax_number": "614-247-6074"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1875 MILLIKIN RD",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432102200",
"telephone_number": "614-292-0110",
"fax_number": "614-247-6074"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIACZ",
"first_name": "MARY",
"middle_name": "LYNN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-14",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "OH",
"license": "35-045382",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0760556",
"state": "OH"
}
],
"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 Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.