NPIMap

Organization Active NPI

Alpha Recovery Center

  • Registered Nurse
  • Columbus, OH
National Provider Identifier
1639771975
Registry record updated Mar 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
Legal business name
ALPHA RECOVERY CENTER
Practice address
1251 W Broad St
Columbus, OH 43222-1359
Phone
(614) 897-9252
Fax
(614) 737-5200
NPI assigned
Nov 11, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2023

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

Authorized official

Name
Nkengafac EtchiNPI 1376969204
Title
NP
Phone
(614) 584-4270

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YA0400X
Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163W00000X Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

1251 W Broad St
Columbus, OH 43222-1359

Mailing address

313 Marjoram Dr
Gahanna, OH 43230-7027
Phone (614) 584-4270

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230331000465 OH Part B Supplier - Clinic/Group Practice 2466837273 Receives reassigned benefits from 2 practitioners
Practice locations: Columbus, OH

National Provider Directory

National Provider Directory
Tax ID family
Alpha Recovery Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3805 N High St
Ste 307
Columbus, OH 43214
Phone (614) 897-9252

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1605052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679011200000",
    "number": "1639771975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 MARJORAM DR",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432307027",
            "telephone_number": "614-584-4270",
            "fax_number": "614-343-1548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 W BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432221359",
            "telephone_number": "614-897-9252",
            "fax_number": "614-737-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALPHA RECOVERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-11",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A",
        "authorized_official_last_name": "ETCHI",
        "authorized_official_first_name": "NKENGAFAC",
        "authorized_official_title_or_position": "NP",
        "authorized_official_telephone_number": "614-584-4270"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Mar 17, 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.