Marielle Grace Reidy, OD, MS

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT.006732 Issued in OH

Practice address

1664 Neil Ave
Columbus, OH 43201-2333

Phone

(614) 292-2020

Fax

(614) 247-6626

NPI assigned

Sep 16, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Marielle Grace Blumenthaler Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1568592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608508800000",
    "number": "1629628292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5460 E LA PALMA AVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928072023",
            "telephone_number": "714-463-7500",
            "fax_number": "714-992-7850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1664 NEIL AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432012333",
            "telephone_number": "614-292-2020",
            "fax_number": "614-247-6626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REIDY",
        "first_name": "MARIELLE",
        "middle_name": "GRACE",
        "credential": "OD, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-16",
        "last_updated": "2020-12-21",
        "certification_date": "2020-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34402",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OPT.006732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIELLE",
            "last_name": "BLUMENTHALER",
            "middle_name": "GRACE",
            "credential": "OD, MS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Patrick Joseph Reid, FNP-C
• Tamara Reid
• Tamu K Reid
• Timothy Reid Jr.
• Colleen C Reidy, DO
• Martha Reigel
• Reign of Care
• Richard Reihing
• Reilly Chiropractic
• Moira A Reilly-Gutridge, LPN

• Optometrist in Columbus, OH
• Providers in Columbus, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.