Individual provider Active NPI

John Kenneth Lodge, PSY.D.

  • Psychologist
  • Columbus, OH
National Provider Identifier
1639421449
Registry record updated Sep 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
P.7194 Issued in OH
Practice address
1800 Zollinger Rd
Columbus, OH 43221-2849
Phone
(614) 293-2920
Fax
(614) 293-5167
NPI assigned
Oct 4, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X P.7194 OH Primary

Addresses

Primary practice location

1800 Zollinger Rd
Columbus, OH 43221-2849

Mailing address

700 Ackerman Rd Ste 2120
Columbus, OH 43202-1559
Phone (614) 293-2920

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141010001971 OH Practitioner - Clinical Psychologist 7719107911 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Osu General Internal Medicine LLCGroup PAC ID 7517103955, 270 clinicians

Practice addresses (Care Compare)

1800 Zollinger Rd
Columbus, OH 43221-2849
Phone (614) 293-7417

2050 Kenny Rd
Columbus, OH 43221-3502
Phone (614) 293-8054

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7194OHMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Osu General Internal Medicine LLC Psychologist CurrentSince Mar 22, 2022 Accepting new patients

Locations

543 Taylor Ave
Fl 2
Columbus, OH 43203
Phone (614) 293-2700

2050 Kenny Rd
Columbus, OH 43221
Phone (614) 293-8054

700 Ackerman Rd
Ste 2120
Columbus, OH 43202

1800 Zollinger Rd
Fl 5
Upper Arlington, OH 43221
Phone (614) 293-2700

1800 Zollinger Rd
Upper Arlington, OH 43221
Phone (614) 293-2130

Organizations & group practices 1

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": "1349308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789516800000",
    "number": "1639421449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 2120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "614-293-2920",
            "fax_number": "614-293-5167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 ZOLLINGER RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432212849",
            "telephone_number": "614-293-2920",
            "fax_number": "614-293-5167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LODGE",
        "first_name": "JOHN",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-04",
        "last_updated": "2026-09-16",
        "certification_date": "2026-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "P.7194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.